LABORATORY MANAGEMENT

review
Presented BY
PETER JACKSON MS MLS (ASCP)
CLS MANAGEMENT REVIEW
Excerpted from:
Quick Review Q&As for CLS Examinations
By
Valerie Dietz Polansky

Medical Laboratory Management and Supervision

By
Lionel A. Varnadoe

Success In CLS
by
Ciulla, A.P and Lehman D.C.
 MANAGEMENT REVIEW

**NOTE: The material to be presented has been obtained from

noted bibliography sources and I believe it will be useful to
those who are, or aspire to be in Management regardless of
their area of interest. It will also be of much use for those
students who are planning on taking the ASCP registry
certifying examination, as the National Accreditation Agency
for Clinical laboratory Sciences (NAACLS) requires that
Laboratory Management training be issued for those students
who wish to take the ASCP registry examination.
 CLS MANAGEMENT REVIEW

This presentation consists of definitions and

terminology in the following areas:

I.MANAGEMENT THEORY
II.REGULATIONS AND ACCREDITATION
III- PERSONNEL MANAGEMENT
IV.FINANCIAL MANAGEMENT
V.LEGAL ISSUES
VI- EDUCATION
 Management Review

I- MANAGEMENT THEORY
 Management Review

Management- coordination of human and non-human

resources toward the accomplishment of
organizational goals.
Mission statement- statement of an organizations
fundamental purpose for being.
Organizational goals- organizations broad, long-term
ambitions.
Objectives- directives that describe how a goal will be
achieved.
 Management Review

Management positions
1 Director- directs affairs of an organization by
establishing goals and priorities that determine the
direction the organization will take. His/her role is
primarily one of broad policy-making.
2 Administrator- administers or runs organization
within the framework of various directives and
policies given. (cont.)
 Management Review

(cont.)

3Manager- takes charge of management or oversees

the functioning of an activity to achieve a set goal or
purpose.

4Supervisor- oversees activity of others to help

them accomplish special tasks or to perform
scheduled activities most efficiently.
 Management Review

Management Skills
(Skill= adeptness, cleverness)

Organizational Skill- Ability to conceptualize and apply

the management process, systematize work flow,
make decisions, and communicate with co-workers.
People skill- Understanding of the basic theories of
human needs and work motivation.
Financial management skill- effective use of and
accounting for the monetary value of the company.
Technical skill- Skill required to transform resources
into products/services
 Management Review

Four management functions:

1 Planning- devising long-range and short-range plans,

establishing goals and objectives, and formulating
policies to carry out objectives.

2 Organizing- coordinating resources to achieve plans

and define lines of authority and workflow.
 Management Review

3 Directing- communicate, motivate, delegate, and

coach . That is, persuading employees to perform
tasks that help the organization accomplish its
mission and goals.

4 Controlling- defining standards of performance,

developing a reporting system, and taking corrective
actions when and where needed.
 Management Review

Inventory Management- a continual process of checking

stock levels, ordering supplies to meet current needs.
Three methods to track inventory levels:
1 Perpetual system- keep account of inventory every
time a product is used.
2 Periodic system- once a week the stock level is
counted.
3 Random checks- documenting value of supplies at
specific times
 Management Review

MANAGEMENT TERMS
1- Organizational chart- chart showing lines of
supervision and interrelationships of staff and
departments.
2- MBO- Management by Objectives-
A system that uses performance objectives as a means
of accomplishing management goals. Objectives should
follow well, thought-out plans and long term goals, be
accepted by employees, and have a built-in, continuous
feedback mechanism.
 Management Review

3 TQM= Total Quality Management-

A quality management system that emphasizes the
importance of customers and processes.
4 CQI= Continuous Quality Improvement
A quality management system that sees quality as
something that needs to be improved on an on-going
basis. It provides a problem solving method to
identify and resolve chronic problems and emphasizes
teamwork.
 Management Review

5- Six Sigma
A system that uses statistics to measure quality
improvements. Six sigma means, no more than 3.4
defects per million.
Six Sigma originated as a set of practices designed to
improve manufacturing processes and eliminate
defects, but its application was subsequently
extended to other types of business processes as
well. In Six Sigma, a defect is defined as any process
output that does not meet customer specifications, or
that could lead to creating an output that does not
meet customer specifications.
 Management Review

6Lean management
A system that looks at all aspects of a system and
attempts to improve the speed of process by reducing
or eliminating waste, including excess motions/steps
of the testing personnel. This type of management
may lead to reorganizing the laboratory into
automated, semi-automated, and manual work-cells
and the cross-training of staff.
7ISO 9000- Guidelines developed by International
Organization for Standardization that provide a
framework for quality management and quality
assurance.
 Management Review

Problem Solving
What is a problem?- It may be something that is
difficult to deal with; that may be a source of
trouble, or worry; a question raised for inquiry
consideration or solution that may lead to imperfect
processes. The persons best qualified to solve
problems with work processes are the employees
involved in the work process.
 Management Review

STEPS IN PROBLEM SOLVING

1 Define the problem by identifying and selecting the
problem
2Identify and analyze root causes of the problem
3- Generate a potential solution; identify a remedy
4- Select and plan the solution and verify that it
actually works
5 Standardize and implement the solution
6 Establish process to assure that problem does not
recur
 Management Review

Douglas McGregor Theory X / Theory Y Hypotheses

or Theories of Management
Douglas M. McGregor (1902-1964)- among other
accomplishments, was Management Professor at the
MIT School of Management and taught at the Indian
Institute of Management in Calcutta . He
hypothesized that human behavior could be looked at
in two different ways that he called Theory X and
Theory Y.
 Management Review

Douglas McGregor Theory X / Theory Y Hypotheses

or Theories of Management

1 Theory X- employees are basically lazy and do not

want responsibility. They are motivated by money and
threat of punishment. Must be directed.

2 Theory Y- employees are creative and willing to put

their talents to use. They can be self-directed.
 Management Review

Theory X
Work is inherently distasteful to most people
Most people are not ambitious, have little desire for
responsibility, and prefer to be directed
Most people have little capacity for creativity in
solving organizational problems
Motivation occurs only at the physiologic and safety
levels
Most people must be loosely controlled and often
ordered to achieve organizational objectives,
 Management Review

Theory Y
Work is as natural as play if the conditions are
favorable
Self-control is often indispensable in achieving
organizational goals
The capacity for creativity in solving organizational
problems is widely distributed in the population
Motivation occurs at the social, esteem, and self-
actualization levels.
People can be self-directed and creative at work if
properly motivated
 Management Review

Styles of Management

1 Participative style- responsibility and authority are

shared equally between managers and employees,
2 Consensus style- everyone has input and the manager
tries to get at least partial agreement from staff.
3 Laissez-faire style- manager leaves decisions to
staff.
4 Authoritarian style- manager makes decisions without
consulting staff.
 Management Review

Abraham Maslows Hierarchy of Needs

(Theory of Human Motivation)
Professor Maslow was an American Professor of
psychology at Brandeis University, Brooklyn College,
Columbia University, and the New School for Social
Research. He founded humanistic psychology and
created Maslows Hierarchy of Needs.
To facilitate understanding of his theory, he created a
pyramid showing levels of human needs, that is,
psychological and physical. Upon arriving at the peak
of the pyramid a human being reaches self-
actualization.
 Abraham Maslows Hierarchy of Needs

Theory of Human
Motivation
 Management Review

Abraham Maslows Hierarchy of Needs

(Theory of Human Motivation)
1 Physiological- (lowest level)-food, clothing, shelter
(primary need). Usually associated with money. Money
can satisfy physiologic needs.
2 Safety- (next level)- includes protection from
physical harm, ill health, and economic disaster.
3 Social needs- includes needs for both giving and
receiving affection and love, and need to belong or
feel as part of social groups. (cont.)
 Management Review(cont.)

4- Esteem- (ego need)- need to be recognized for what

one does. Need for respect from others; the feeling
of achievement, appreciation, recognition, and status.
Can be divided into self-esteem, development of
self-confidence and self- respect, and esteem from
others. That is, recognition by management and
others.
5- Self-actualization or self-fulfillment- (highest level
of need)- need to become everything one is capable of
becoming
 Management Review

Maslow emphasized that self-actualization cannot

normally be reached until other lower order
necessities of need are satisfied. Once reached, they
possess an ability to detect the spurious (bogus,
phony), fake, and dishonest in personality). They get
to judge people in an appropriate manner.
II-REGULATIONS AND ACCREDITATION
 Management Review- Regulations

Definitions

Accreditation- approval of an institution

demonstrating that it meets all formal standards as
defined by the accrediting body.
Certification- official acknowledgment of the passing
or qualifying examination.
Licensure- process by which a competent public
authority grants permission to engage in a specific
professional practice,
 Management Review- Regulations

Certifying Agencies

1- CLIA 88 - Congress passed the Clinical Laboratory Improvement

Amendments (CLIA) in 1988 establishing quality standards for
all laboratory testing to ensure the accuracy, reliability and
timeliness of patient test results regardless of where the test
was performed.
A laboratory is any facility that does laboratory testing on
specimens derived from humans to give information for the
diagnosis, prevention, treatment of disease, or impairment of, or
assessment of health. (cont.)
 Certifying Agencies

(cont.)
CLIA is user fee funded; therefore, regulated
facilities cover all the costs of administering the
program.
Centers for Medicare & Medicaid Services (CMS)
assumes primary responsibility for financial
management operations of the CLIA program.
The categorization of commercially marketed in vitro
diagnostic tests under CLIA is the responsibility of
the FDA. (cont.)
 Certifying Agencies

CLIA 88 REVIEW

What is CLIA--Clinical Laboratory Improvement Amendments

of 1988 (CLIA).

It was enacted as result of reports of inaccurate test results from

Pap (Cytological ) smears.
A number of questions were raised about how labs functioned and
what quality control procedures existed.
It became comprehensive plan to improve the quality of labs.
In 1987 12,000/200,000 labs regulated . In 2002 the number went
up to 170,000 labs
Since CLIA 88 and state regulations are similar, the regulations
that are more stringent take precedence.
 Certifying Agencies

2- American Association of Blood Banks (AABB)-

international organization established to promote the
highest standards in all aspects of blood banking.

3 American Society for Clinical Pathology (ASCP)-

professional organization for individuals working in
clinical laboratory medicine. The ASCP Board of
registry offers certification examination s for clinical
laboratory personnel.

4 College of American Pathologists (CAP)- accredits

laboratories. Proficiency testing are administered
every two years.
 Certifying Agencies

5 Food and Drug Administration (FDA)- reviews and

approves new analytical methods prior to marketing
by the manufacturer laboratories. Also inspects all
Blood Banks to assure the ongoing safety of the
nations blood source.

6 Joint Commission on Accreditation of Healthcare

Organizations (JCAHO) - evaluates and accredits
most of the healthcare organizations in the U.S.
 Management Review- Regulations

DEEMED STATUS
Recognition granted by CMS for organizations whose
voluntary standards meet or exceed the federal
requirements. Agencies having deemed status are:
1 Joint Commission on Accreditation of Healthcare
Organizations (JCAHO).
2 College of American Pathologists (CAP).
3 Commission of Office Laboratory Accreditation
(COLA)
 Management Review- Regulations

POINT OF CARE TESTING (POCT)

Point of Care Testing: Laboratory testing, at any

complexity level, that is performed and documented
within the hospital organization at sites of immediate
patient care (e.g. clinic, nursing unit, ED), where the
results of the test are used for clinical decision
making. It does not pertain to histological or
cytological assessments or to testing performed in
settings outside of those associated with immediate
patient care. (cont.)
 Management Review- Regulations

(cont.) NOTE: Point-of Care Testing may also be

referred to as decentralized testing, ancillary testing
and bedside testing. Based on Clinical Laboratory
Improvement Amendment (CLIA) criteria, point-of-
care testing is generally divided into two categories
of complexity, (waived and non-waived testing).
 Management Review- Regulations

(cont.) Waived Testing: Non-critical tests which have

been approved by the FDA for home use, employ
methodologies that are so simple and accurate as to
render the likelihood of erroneous results negligible,
or pose no reasonable risk of harm to the patient if
performed incorrectly. Waived test lists are
constantly being updated.
 Management Review- Regulations

Non-Waived Testing
Classified as:
1 Moderately Complex Testing: Tests which require minimal
scientific and technical knowledge and training to perform
accurately, operational steps are either automatically executed
or easily controlled, and minimal interpretation and judgment are
required.
2 Highly Complex Testing: Tests which require specialized
scientific and technical knowledge, training and experience to
perform accurately, operational steps require close monitoring
or control, and extensive independent interpretation and
judgment are required.
 Management Review- Regulations

Under CLIA 88:

Minimum education required to perform moderate
complexity testing a high school diploma or
equivalent.

To perform high complexity testing- minimum education

required is an associate degree in laboratory science.
Personnel required in high complexity laboratories:
a- Director b- consultant c- technical supervisor
d- general supervisor e- testing personnel
 Management Review- Procedure Manuals

Definitions-
Procedure- instructional document that provides
explanations and step-by-step directions on how to
perform a task, or process.
Procedure Manual- a manual that contains procedures
that apply to specific work tasks and duties. These
manuals must be reviewed annually by the laboratory
director. They must be approved, signed, and dated
by the director.
 Management Review- CAP Requirements and Guidelines

Retention of Records
Most laboratory records must be retained for at least
two years. These include:
1Patients tests results and reports
2 Instrument printouts
3 Accession records
4 Quality control records
5 Instrument maintenance records
6Proficiency testing records 7-
Quality improvement records
(cont.)
 Management Review- CAP Requirements

Retention of Specimens
Specimen 24 hrs 48hrs 7 days

Whole Blood xx
CSF xx
Urine xx
Specimens
Blood Films xx
Microbiology xx
slides
Body Fluids xx
 Management Review- CAP Requirements and Guidelines

(cont.) Donors and recipient records must be retained

indefinitely.

After discontinuance, procedures must be retained for

two years.
 Management Review- CAP Requirements and Guidelines

Key Indicators- issues critical to patient outcomes that

are monitored regularly and evaluated for
opportunities to improve patient care. Examples are:
specimen identification, turnaround time, reporting of
critical values.

Sentinel events- events that result in unanticipated

death or permanent loss of function, not related to the
natural cause of patients illness or underlying
condition.
 Management Review- CAP Requirements and Guidelines

Root Cause Analysis- a process for identifying causes of

an unfavorable outcome. It focuses on identifying
changes that can be made to systems and processes
to reduce the risk of such events occurring again.
III- PERSONNEL MANAGEMENT
 PERSONNEL MANAGEMENT

It is unacceptable during a job interview, or include on a

job application the following:

1- Race 2- Age 3- Marital Status

4- Religious Affiliation 5- Spouses Occupation
6- Child Care Arrangements 7- Transportation
8- Credit History 9- History of Arrests
 PERSONNEL MANAGEMENT

Job Description must include:

1 Position title
2 Job responsibilities
3 Qualifications
 PERSONNEL MANAGEMENT

1963 Equal Pay Act- an act that outlaws

discrimination in pay based on the gender.

Prospective employees may submit to background

check, drug screen, and physical examination only
after the job offer has been made.

Employees performing jobs tat require color

discrimination may be tested for visual color
discrimination.
 PERSONNEL MANAGEMENT

American with Disabilities Act- states that employers

must provide reasonable accommodations to
employees with disabilities.
Ergonomics- science of designing work-stations that are
compatible with the human anatomy.
 PERSONNEL MANAGEMENT

Testing personnel and Personnel Records

Assessment of testing personnel competency in moderate and

high complexity labs should be made semiannually during the
first year and annually thereafter; or whenever test
methodology or instrumentation has been changed.

Records that should be maintained in employees files include:

a- Application, b- Documentation of credentials review by lab.
director c- Performance standards for position d- Record of
job training e- Job description f- Performance appraisals
g- Records of C.E. h- Records of vaccination
 PERSONNEL MANAGEMENT

NATIONAL LABOR RELATIONS ACT

Federal legislation that gives the employees the right to

engage in self-organization and collective bargaining.
IV- FINANCIAL MANAGEMENT
 FINANCIAL MANAGEMENT

Budgets
A budget is a sum of money allocated for a particular
purpose. Two types of budgets are: operating budget
and capital budget.
Operating budget- includes items needed to conduct
business such as personnel and operating expenses.
Typical items in an operating budget are:
1 Salaries
2 Benefits
3 Supplies
4 Repair and maintenance of instruments
 FINANCIAL MANAGEMENT

Capital budget- budget for non-expendable items with a

life expectancy of more than one fiscal year and a
cost exceeding a set minimum amount, such as an
automated analyzer. These are purchases or projects
that meet specific guidelines of time, price, and
purpose.
 FINANCIAL MANAGEMENT

Profit and Loss Statement (P&L) -

A financial statement that summarizes the revenues,
costs and expenses incurred during a specific period
of time - usually a fiscal quarter or year. These
records provide information that show the ability of a
company to generate profit by increasing revenue
and reducing costs. The P&L statement is also known
as a "statement of profit and loss", an "income
statement" or an "income and expense statement".
 FINANCIAL MANAGEMENT

Reimbursement-something (such as money) given or

received as payment or reparation. For example a
laboratory may apply for reimbursement after a
procedure or test has been completed ( a service
rendered) and CPT code has been properly
designated. CPT stands for Physicians Current
Terminology. This is a publication that assigns codes
for all medical procedures grouped according to
common disease characteristics.
 FINANCIAL MANAGEMENT
FISCAL YEAR

A 12-month period over which a company budgets its spending. A

fiscal year does not always begin in January and ends in
December; it may run over any period of 12 months. The fiscal
year is referred to by the date in which it ends. For example, if
a company's fiscal year ends October 31, 2006, then everything
between November 1, 2005 and October 31, 2006 would be
referred to as FY 2006. Not using the actual calendar year gives
many companies an advantage, allowing them to close their books
at a time which is most convenient for them.
 FINANCIAL MANAGEMENT

Financial Key terms

FTE- Fulltime Equivalent-2080 person hours worked
in one year (40 hours a week x 52 weeks). Directly
under the accountability of Managers.
Exempt employees- salaried employees that do not
receive overtime pay.
Nonproductive (benefits) hours- hours for which the
employee is compensated but not available for work
such as, vacations, sick time, and jury duty.
(cont.)
 FINANCIAL MANAGEMENT

Productive (worked) hours- actual hours worked ,

including overtime, and time spent in education or
training.
Fixed costs- expenses that do not fluctuate when the
volume of work changes over a short term.
(instrument leases, maintenance contracts, computer
services, management salaries, and employee
benefits).
Variable costs- expenses that fluctuate with work
load. (labor, supplies, reagents, disposables).
(cont.)
 FINANCIAL MANAGEMENT

Direct costs- costs associated directly with

performance of tests (supplies, reagents, controls
and standards, disposables).
Indirect costs- overhead expenses (administration,
plant maintenance, utilities, taxes, insurance).
Strategic investments- investments that will not
show a positive return but which are needed for the
laboratory to remain competitive (computer system)
 FINANCIAL MANAGEMENT

Ways of acquiring laboratory equipment by purchase,

rental or lease.
Depreciation- if instrument is purchased, depreciation
is the process by which the cost of the asset is
reduced over the expected life of the asset.
Just-in Time inventory management- guarantee from
the supplier to deliver an item at the exact time of
need.
Break-even point- point at which revenue equals
expenses
 FINANCIAL MANAGEMENT

Laboratory Management Index Program- College of

American Pathologists (CAP) peer comparison
program of productivity, use, and financial operations.
The Medicare and Medicaid Legislation of 1966-
provides a mechanism for financing the health care of
the elderly and poor.
The Center for Medicare and Medicaid Services
(CMS)- administer Medicaid and Medicare programs.
Tax Equity and Fiscal Responsibility Act (TEFRA)- a
federal program that sets caps on the amount of
revenue paid for health care expenditures for
Medicare and Medicaid patients.
 FINANCIAL MANAGEMENT

What are DRGs?- Diagnosis Related Groups. They

determine the amount hospitals are paid for the care
of Medicare and Medicaid patients. Payment is based
on the patients diagnosis and not on services
provided.
HMOs- Hospital Maintenance Organizations. Provide
coverage of designated health services needed by
plan members for a fixed premium.
CPT Codes (Current Procedural Terminology)- A
schedule of medical services and procedures listed by
the American Medical Association. Each procedure or
test is assigned a code that is the basis for
reimbursement.
V- LEGAL ISSUES
 LEGAL ISSUES

Respondeat Superior (Let the master answer for

the actions of the servant)- refers to the fact that
an employer, supervisor, or laboratory director can be
held liable for the actions of an employee's
malpractice.
Malpractice- improper or unskillful care of a patient
by a member of the healthcare team or any
unprofessional misconduct or unreasonable lack of
skill or fidelity to professional duties.
Negligence- a violation of duty to exercise reasonable
skill and care.
 LEGAL ISSUES

Breach of duty- failure to exercise the required

degree of care.
Proximate cause- a direct relationship between the
failure to exercise care and the injury that resulted
to the plaintiff.
Subpoena duces tecum- a legal request for records
Informed consent- consent obtained from the patient
for an invasive or diagnostic procedure after he/she
has been informed of the risks and alternatives
 LEGAL ISSUES

False Claims Act- Federal legislation that prohibits

presenting a false claim to the government such as
billing for services not medically necessary, or
services not provided, and filing duplicate claims for
the same service.
Anti-kickback law- Legislation that prohibits
remuneration in return for patient referrals.
Remuneration not only involves money but also
providing the physician with a phlebotomist, providing
free laboratory tests, and providing fax equipment
and computers for a physician's office.
VI- EDUCATION
 EDUCATION

Agencies accrediting educational programs in clinical

laboratory science-

1 NAACLS- National Accreditation Agency for Clinical

Laboratory Science
2 ABHES- Accrediting Bureau of Health Education
Schools
 EDUCATION
Educational Program Terms

Accreditation Standards- requirements that a

program must meet in order to obtain and maintain
accreditation. Formerly known as Essentials.
Affiliation Agreements- Contracts between an
academic institution and a site that provides clinical
experience for students. It delineates
responsibilities of both institutions and the rights of
students.
 EDUCATION

Competency statements- statements describing the

skills and tasks an individual should be able to
perform following completion of the curriculum.

Goal- general outcome for an entire course or

program
Objective- specific, observable, and measurable
learning outcomes written for individual units of
study.
 EDUCATION

Task Analysis- description of knowledge and skills

needed for competence in the work setting.
Instructional objectives- statements that describe
what a student should be able to accomplish upon
completing a unit of instruction.

Domains of learning:
1- Cognitive (facts, knowledge)
2- Psychomotor ( physical skills)
3- Affective (attitude, values)
 EDUCATION

Taxonomy levels of cognitive skills:

1 Recall- ability to recall or recognize previously
learned knowledge.
2Interpretation- ability to utilize recalled
knowledge to interpret or apply verbal, numeric, or
visual data.
3Problem solving- ability to utilize recalled
knowledge and interpretation of recalled criteria to
resolve a problem and/or make appropriate decisions.
 EDUCATION

Three styles of learning:

1 Visual- learner learns best by seeing. Techniques

are by reading assignments, overhead transparencies,
slides, diagrams, videos, and demonstrations.

2Auditory- learns best by hearing lectures, tapes,

and discussions.

3Kinesthetic- learns best by doing. That is, doing

laboratory work, role-playing, and group work.
 EDUCATION

Types of testing:

Norm- referenced tests- tests on which scores are based on a

students relative position in a group. Grades result in a typical
bell-shaped curve. Some students must receive low grades.
Criterion-referenced tests- scores are based on a
predetermined standard, without reference to the performance
of others.
Summative tests- comprehensive tests designed to assess the
mastery of the body of knowledge. For example, final
examinations.
Formative tests- tests given throughout the course of study.
 EDUCATION

On test questions-
Highest odds of guessing correct answer? True or
false
Which measure highest level of learning? Essays

Discrimination index- measurement that compares

the performance of the top 25% of students and
bottom 25% of students on a particular question.

Halo effect- when a students good performance in

one area influences their evaluation on another area.
 EDUCATION

Contrast error- when a student receives a rating

higher or lower than he/she deserves based on a
favorable or unfavorable comparison to another
student.

Error of central tendency- tendency to rate everyone

toward the middle of the scale.
 EDUCATION

Outcomes assessment- a systematic evaluation of the

program and institutional effectiveness. Examples:
1Student completion rate
2 Grade-point averages
3 Portfolios
4Scores on certification exams
5- Job placement rate
 EDUCATION

Family Educational Rights and Privacy Act- Students

have the right to see their educational records. Also
it prohibits disclosure of such records without the
students written consent.

On students disciplinary dismissal from the program-

the students have the right to a hearing and appeal.
 MANAGEMENT AND EDUCATION REVIEW

Bibliography

Ciulla, A.P and Lehman D.C. (2010). Success! In Clinical Laboratory Science. New Jersey: Pearson
Education, Inc.

Polansky, V.D. (2006). Quick Review Q&As for clinical laboratory science examinations. Florida:
Publishing Enterprises of Sarasota, Florida

Senhauser, D.A. and Snyder, J.R. (1989). Administration and Supervision in Laboratory Medicine
. Philadelphia :J.B. Lippincot

Varnadoe, L.A. (1996). Medical laboratory management and supervision. Philadelphia: F.A. Davis
Company

WIKIPEDIA Sources
**NOTE: The material presented has been obtained from noted bibliography sources for the
sole purpose of assisting Clinical Laboratory Science students who wish to pursue
certification by the American Society for Clinical Pathology as well as to comply with
standards as required by the National Accreditation Agency for Clinical laboratory Sciences
(NAACLS)