Laboratory Management - PRELIM Lecture PDF

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UnselfishLife

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Lyceum of the Philippines University

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laboratory management medical laboratory management functions healthcare management

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This document is a lecture on laboratory management, covering topics such as personnel types, different sections of the lab (clinical chemistry, clinical microscopy, hematology, etc.), and information management. It describes the roles of staff members, organizational structures and processes, such as testing, reporting, etc. It also touches on some management theories and approaches.

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INTRODUCTION TO LABORATORY 1 MANAGEMENT LABORATORY Provide physicians and other health care professionals with information to : ▸ 1. detect disease or predisposition to disease; ▸ 2. confirm or reject a diagnosis; ▸ 3. establish prognosis; ▸ 4. guide pa...

INTRODUCTION TO LABORATORY 1 MANAGEMENT LABORATORY Provide physicians and other health care professionals with information to : ▸ 1. detect disease or predisposition to disease; ▸ 2. confirm or reject a diagnosis; ▸ 3. establish prognosis; ▸ 4. guide patient management; ▸ 5. monitor efficacy of therapy 3 LABORATORY PERSONNEL Generalist – trained in multiple areas of the laboratory with staffing flexibility and wide area of knowledge Laboratory supervisor – individual responsible for staffing and scheduling the laboratory Specialist/Section head – person trained and experienced in one specific laboratory discipline Medical Technologist – person with expertise in testing methods and has the ability to analyze and solve problems o a bachelor degree holder in medical technology program, some requires certification of practice Medical Technician (laboratory aides) – knowledge may be lacking to review or troubleshoot test results 4 LABORATORY SECTIONS ▸ CLINICAL CHEMISTRY o Patient’s specimen is tested for various chemical components o Monitors and evaluates the performance of chemical analyses of body fluids o Serum, Plasma and whole blood o Example: glucose, cholesterol, triglyceride, hormones, enzymes ▸ CLINICAL MICROSCOPY o Performs scientific analysis of non-blood body fluids such as urine, semen, and stool. o Examined and performed through macroscopic and microscopic analysis o Example: urinalysis, fecalysis, FOBT (fecal occult blood testing), and pregnancy test 5 LABORATORY SECTIONS ▸ HEMATOLOGY o Performs routine and special tests on the component of whole blood and to other body fluids o Analyzing blood samples and identifying white or red blood cell abnormalities. o Example: CBC (complete blood count), differential count, platelet count BLOOD TRANSFUSION SERVICE o Prepares and performs cross-matching for the compatibility of patient’s blood to donor’s blood which includes whole blood, packed red blood cells, platelet concentrates and plasma transfusions o Testing blood for viruses that might be transmitted during transfusion 6 o Example: cross-matching, blood typing, antibodies screening ▸ HISTOPATHOLOGY AND CYTOLOGY o Surgical specimens (such as organs) are examined for pathologic diagnosis and interpretation Examines tissue under microscope to detect characteristics of cell structure indicative of disease ▸ IMMUNOLOGY AND SEROLOGY o Patient’s sample are analyzed to identify any present antibody or antigen that causes any medicalconditionthat may be considered as infectious o Example: HIV, hepatitis, measles 7 MANAGEMENT MANAGEMENT ▸ reaching Management organizational is the process goals by of working with and through people and other organization resources which attains organization goals in an effective and efficient manner. ▸ “Working with and through people to accomplish a common mission.” 9 BASIC ROLES OF A MANAGER PERSON SERVANT REPRESENTATIVE Talent and knowledge Perform the task and Representative of the Managers are made work of the institution. owners not born. Provide means for the Representatives those Responsible for and to staff to meet the needs they supervise other people. of their patients and customers. 10 MANAGEMENT PROCESS ▸ A Continuum of functions that the manager must perform to ensure the smooth operations of an organization. 11 FOUR MANAGEMENT FUNCTIONS 1. PLANNING – means identifying goals for future organizational performance and deciding on the tasks and use of resources needed to attain them. o In other words, managerial planning defines where the organization wants to be in the future and how to get there. o Planning includes setting of goals and deciding activities o It includes goals and objectives, vision and mission, and strategies 2. ORGANIZING – involves assigning tasks, grouping tasks into departments, delegating authority, and allocating resources across the organization. o Organizing activities and people o It follows planning and reflects how the organization tries to accomplish the plan 12 FOUR MANAGEMENT FUNCTIONS 3. Leading – is the use of influence to motivate employees to achieve organizational goals. o Leading means creating a shared culture and values, communicating goals to employees throughout the organization, and infusing employees with the desire to perform at a high level. o It includes motivating, communication, leadership, and decision-making 4. Controlling – means monitoring employees’ activities, determining whether the organization is on target toward its goals, and making corrections as necessary. o Establishes targets and measures performance o Includes systems or processes and strategic human resources 13 FOUR (4) MANAGEMENT SKILLS 1. ORGANIZATIONAL SKILLS 4. TECHNICAL SKILLS ▸ Conceptualize and apply management process ▸ Management of physical resources (supplies, ▸ Systematize workflow equipment,facilities)tooperationalparameters. ▸ Make decisions ▸ Communicate with co-worker ▸ It is the understanding of and proficiency in the 2. PEOPLE SKILLS performanceof specifictasks. ▸ ▸Understand basic theories of human needs ▸ Includes mastery of the methods, techniques, Work motivation and equipment involved in specific functions 3. FINANCIAL MANAGEMENT such as engineering, manufacturing, or finance. Effective use and accounting of monetary assets 14 TYPES OF MANAGEMENT ▸ Managers use conceptual, human, and technical skills to perform the four functions of planning, organizing, leading, and controlling in all organizations ▸ Managers are responsible for different departments, work at different levels of the hierarchy, and meet different requirements for achieving high performance ▸ In a vertical differentiation , it involves the installation of a “chain of among employees and managers command” ▸ In horizontal differentiation , it separates the workers by their assigned task such as accounting, sales, or computer networking 15 ▸ MANAGEMENT LEVELS IN THE ORGANIZATIONAL HIERARCHY 16 MANAGEMENT LEVELS IN THE ORGANIZATIONAL HIERARCHY TOP- LEVEL MANAGERS ▸ ▸Responsible ▸ for controlling and overseeing the entire organization Develop goals, strategic plans, company policies, and make decisions on the direction of the business. Ex. Board of Directors, President, Vice President and CEO MIDDLE MANAGERS ▸ ▸Responsibleforexecutingorganizationalplanswhichcomplywiththecompany’s ▸ policies. Act at an intermediary between top level management and low level management Ex. General manager, branch manager, and department managers. FIRST LEVEL MANAGERS ▸ ▸directly ▸▸ responsible for the production of goods and services. They are the first or second level of management First-line managers are variously called office manager, section chief, line manager, supervisor. Their primary concern is the application of rules and procedures to achieve efficient production, provide technical assistance, and motivate subordinates. 17 18 ESSENTIAL MANAGEMENT THEORIES 1. SYSTEMS THEORY ▸ Ludwig von Bertalanffy (1901-1972) Systems Theory encourages you to realize that your business is a system and is governed by ▸ the same lawsand behaviors that affect every other biological organization 2. PRINCIPLES OF ADMINISTRATIVE MANAGEMENT ▸ Miner and engineer Henri Fayol (1841-1925) ▸ His principles of administrative management as a top-down approach to examining a business. He believed ▸ that management is a science which can be taught and argued that there are 6 basic business activities:Technical,Commercial, Financial, Security, Accounting, and Managerial(whichisfurtherdivided into five: planning, organizing, commanding or leading, coordinating, and controlling) He also developed the 14 ▸ Principles of Management and 6 Functions of Management that work in conjunctiontothemanagementprinciples. 19 3. BUREAUCRATIC MANAGEMENT ▸ Max Weber (1864-1920) ▸ It took a more sociological approach when creating his bureaucratic management theory. ▸ Weber’s ideas revolve around the importance of structuring your business in a hierarchical manner with clear rules and roles. ▸ An organization will be most efficient if it uses a bureaucratic structure ▸ Bureaucracy – administrative government or social system with a hierarchical structure and complex rules and regulations 20 4. SCIENTIFIC MANAGEMENT ▸ Frederick Taylor (1856-1915) ▸ “The FATHER OF SCIENTIFIC MANAGEMENT” ▸ He was an American mechanical engineer who experimented in various ways to determine the most efficient effective ways to get the task done ▸ It promotes standardization, specialization, assignment based on ability, and extensive training and supervision. 21 5. THEORIES X AND Y ▸ - Douglas McGregor (1906-1964) an American management professor. The XandYtheory ofmanagement assumes thereare twodifferenttypes ofworkers. 1.Theory X w orkers, proposedthatemployees are apatheticor disliketheirwork. ▸ Managers who adhere to Theory X are often authoritarian and will micromanage everything because they don’t trust their employees. ▸ Theory X workers lack ambition and drive and need to be ordered around by bosses to do anything 2.Theory Yworkers ,ontheotherhand,enjoyworkandstrive forself-fulfillment ▸ Managers who adhere to Theory Y include their employees in the decision-making process andencouragecreativityatalllevels. ▸ Theory Y proposed that employees are self- motivated, responsible, and want to take 22 ownershipoftheirwork. 23 ORGANIZING & 2 STAFFING ORGANIZING ▸ ORGANIZING – is a management function that provides the relationship between people and the activities that they will undertake as to fulfill their organizational objectives. -It includes establishing the structure to carry out plans, to determine the most appropriate type of patient care delivery, and to meet unit goals -In organizing phase, relationships are defined, procedures are outlined, equipment is ready, and tasks are assigned ▸ ORGANIZATION – is an entity that results from people joining together in -Common goal in the laboratory: to provide accurate and precise laboratory results and analysis ▸ ORGANIZATIONAL SYSTEM – is defined as self-contained collection of interacting interdependent components, working together toward a common purpose. - Step-by-step procedure inside an organization ▸ ORGANIZATIONAL STRUCTURE – refers in which a group is formed, has 25 means in channeling authority and making decisions FUNCTIONS OF ORGANIZATIONAL SYSTEM 1. INPUT MECHANISM –The process through which needed resources are acquired and replaced; any resources 3. OUTPUT MECHANISM –The process of delivering the goods and services produced to the external environment. that are used to create services o Test Result o People (ex. staffs and patients) o Consultation o Test request o Salaries o Specimen o Information (ex. diagnosis) o Information supplies (ex. computer) o Wastes o Financial resources 2. TRANSFORMATION –The internal process whereby resources received through the input channels. o Test performance o Personnel o Instrument (ex. machines) 26 o Expertise TYPES OF ORGANIZATIONAL STRUCTURE 1. FLAT / HORIZONTAL / FLATARCHY o Decentralized structure – the decision and authority 2. PYRAMID are pushed downward to lower organization Centralized structure – gives the leader the ultimate control over ▪ Examples: startups and small businesses decision making processes The o There is participation in the lower level of management managers have full control of members o Faster decision-making, faster responses, and better communication. 27 TYPES OF ORGANIZATIONAL STRUCTURE 3.BUREAUCRATIC/LINE/ HIERARCHICAL o Oldest and simplest form o Rule centered structure o Associatedwith chainof command o Authority and responsibility are clearly defined usingsolidlines 28 TWO (2) FORMS OF ORGANIZATION 1. FORMAL BUREAUCRACY (FORMAL GROUPS) o Lines of authority assigned by the owners of the organization. oThemembersofthisgroupknowwhomtheyworkfor,whom they supervise, oDecisionsarefocusedontheauthority 2. INFORMAL GROUPS o Alliance that form outside the boundaries of the formal bureaucracy from the interaction and allegiance of people with common interest. oNotnecessarilyassignedbytheorganization o Based on peers, employees’ common interests, likes, and attitudes 29 ORGANIZATIONAL CHART - The formal written presentation of the structural Plan of the Organization. - We can visual see here the lines representation of authority of flow and of command or the chain of command from TOP TO BOTTOM. * CHAIN OF COMMAND : a series of positions of authority or rank within an organization that are ordered from lowest to highest 30 MEDICAL LABORATORY ORGANIZATIONAL CHART 31 32 INFORMATION 3 MANAGEMENT INFORMATION MANAGEMENT ▸ Information management is a system that incorporates all the processes needed for effectively managing data — both incoming (demographics) and outgoing (test results) patient information. ▸ Laboratory directors need to ensure that the laboratory has an effective information management system in place in order to achieve accessibility, accuracy, timeliness, security, confidentiality and privacy of patient information. IMPORTANT ELEMENTS OF INFORMATION MANAGEMENT ▸ Unique identifiers for patients (e.g. unique hospital codes, ankle bracelets, patient number) and samples (e.g. manually labelled or bar codes) ▸ Standardized test request forms (requisitions) o should have complete necessary information such as name, age, date, laboratory test, and physician ▸ Logs and worksheets Logs allow for recording data at the time of arrival of the sample in the laboratory; used for ❑ traceability Worksheets are documents of patients’ samples which are already running during a given ❑ procedure ▸ Checking processes to assure accuracy of data recording and transmission o always have two people review the data description to verify its accuracy 35 o electronic checks that are built into their system; it requires duplicate entry of data IMPORTANT ELEMENTS OF INFORMATION MANAGEMENT ▸ Protection against loss of data Protection of patient confidentiality and privacy ▸ Effective reporting system ▸ Effective and timely communication ▸ ▪ courier/ mail ▪ electronic mechanisms such as laboratory management systems ▪ telephones 36 COMMUNICATION ▸ COMMUNICATION is the process by which information is exchanged and understood by two or more people, usually with the intent to motivate or influence behavior. ▸ The exchange of thoughts, messages, or information using speech, signals, writing, or behavior ▸ The art and technique of using words effectively to impart information or ideas ▸ A system, such as mail, telephone, television, or computer, for sending and receiving messages 37 FIVE PARTS OF COMMUNICATION ▸ SENDER – original information source of the message ▸ ENCODING – transmitter that converts messages into signals ▸ CHANNEL – means by which the message is conveyed ▸ DECODING – location of the signal that converts the message ▸ RECEIVER – intended target of the message ▸ NOISE – obstructed and impeded by noise; alter or distort the message meant for the receiver 38 39 CYCLE OF COMMUNICATION IN PROCESSING LABORATORY DETERMINATION 40 A RECORD should contain at least the following information: LABORATORY PROCEDURE ✓ ✓Identification ✓✓✓ of the patient Name of the physician ✓ Date and time the specimen was collected ✓ Date and time the specimen was received Date, time and by whom the specimen was examined Condition of any unsatisfactory specimen (QNS – quantity not sufficient) Results and date of reporting 41 TEST REPORT CONTENTS Test reports should be designed so that all information that is needed by the laboratory, the laboratory users, and for any accreditation requirement, is included. The following is a list of test report contents required by ISO 15189: ✓ Identificationoftest ✓ Interpretation of results, where appropriate ✓ Identificationoflaboratory ✓ Applicable comments relating to quality or ✓ Unique identification and location of patient, where adequacy of sample, methodology limitations possible, and destination of the report a name and orotherissuesthataffectinterpretation ✓ addressofrequestor ✓ Identification and signature of the person Date and time of collection, and time of receipt in authorizingreleaseofthereport If relevant, ✓ laboratory ✓ notation of original and corrected result ✓ Date and time of release of report ✓ Primary sample type ✓ Results reported in SI units or units traceable to SI units,whereapplicable Biological reference intervals, where applicable 42 43 DOCUMENTS AND RECORDS ▸ One of the 12 essential elements of the quality system. The management system addresses both use and ▸ maintenance of documents and records. ▸ A major goal of keeping documents and records is to find information whenever it is needed. 44 GENERAL QUALITIES OF A LABORATORY REPORT: Compactness Consistency of terminology, format, and usage of understandability Clear and easy to understand Statement of date and time of collection Gross description and source of specimen when pertinent Sharp differentiation of reference or normal and abnormal values Sequential order of multiple results on single specimen Identification of patient, patient location and physician Assurance of accuracy of transcription of request ❖ Laboratory head is responsible for all laboratory reports. 45 DOCUMENTS VS RECORDS ▸ Documents provide written ▸ Records are the collected information about policies, information produced by the processes, and procedures laboratory in the process of performing and reporting a (WHO). Need to be laboratory test. (WHO) It need to updated or maintained beeasilyretrievedoraccessed. EX: histolab handbook, histolab EX: Sample log book or register, Workbooks policy manual, histolab SOP worksheets, Instrument printouts , Maintenance manual,histolab quality manual, records, Quality control data, EQA/ PT records, histolab safety manual Patient test reports 46 IMPORTANT DOCUMENTS IN CLINICAL LABORATORY 1. QUALITY MANUAL is a document ▸ IT CONTAINS THE FOLLOWING: - The quality manual that describes the quality management The quality policy of the laboratory system of an organization (ISO Reference to all processes and procedures 15189) Table of contents:.-ITSPURPOSEIS TO: o Description of the lab clearly o Staff education and training serve ascommunicate a frameworkinformation for meeting quality system requirements convey managerial commitment to the quality system. 47 IMPORTANT DOCUMENTS IN CLINICAL LABORATORY ▸ Policy Manuals includes: the POLICY MANUAL 2. - state Dress Codes laboratory and institutional policy for Food and smoking rules the guidance of those working in the Telephone use laboratory. Laboratory organizations and reporting relationship ▸ Should reflect the philosophy and Writing, review, and authorization of procedures overall goals of the organization. Vacation and holiday request ▸ Should be approved by the Supply requisition laboratorydirector Absences and late arrival notification Reporting and releasing of test results Specific statements about enforcement of safety rules 48 IMPORTANT DOCUMENTS IN CLINICAL LABORATORY ▸ A good SOP should be: 3. Standard Operating Procedures o detailed, clear and concise, (SOPs) o easily understood by new personnel or students in training - SOPs contain written step-by-step staff when instructions that laboratory o reviewed and approved by the laboratory should meticulously follow o updated on a regular basis performing a procedure. ▸ SOP should have the following: Written SOPs ensure the following: o Title o Consistency o Purpose o Accuracy o Instructions o Quality o Name of Person preparing the SOP o Signatures of approving officials and dates of 49 approval LABORATORY INFORMATION SYSTEM ▸ Computer network of hardware and software for receiving, processing, and storing laboratory data and information. ▸ It can interface with laboratory instruments to transfer data into patient records, evaluate quality control data, and store preventive 50 maintenance records. INFORMATION PROVIDED BY AN LIS ▸ 1. Patient demographics ▸ 2. Work lists – sequence of tests to be performed ▸ 3. Data retrieval (inquiry) Generate patient results : Flag critical values, print reports if ✓ requested. ✓ :Perform delta Results of checks assay are an analyte compared to the most recent previously performed results on the same patient ✓ Patient results can be retrieved electronically at a client or via 51 the Internet with a Web browser. INFORMATION PROVIDED BY AN LIS 4. Quality control: An LIS can analyze quality control specimens and prepare charts and reports (e.g., Westgard rules, Levey-Jennings charts). 5. Quality assurance can provide reports on turnaround time, documentation of critical result reporting, and corrected reports. 6. Management reports: Cost per billable test calculations, test volume, turnaround time, employee hours, workload data, etc. 7. Encoding system 52 COMPUTERIZED SYSTEMS ADVANTAGES DISADVANTAGES ▸ Error reduction ▸ Training ▸ Quality control management ▸ Provision of option for data searching ▸ Time to adapt to a new ▸ Access to patient information ▸ system ▸ Generate reports ▸ ▸ Ability to tracks reports Cost Physical restrictions ▸ ▸ Improved capacity for maintaining Need for backup patient confidentiality ▸ system Financial management ▸ Integration with site outside the lab 53 HUMAN RESOURCES 4 PERSONAL MANAGEMENT ▸ Also known as personnel administration ▸ It is the phase of management concerned with the engagement and effective utilization of manpower to obtain optimum efficiency of human resources. ▸ It is an effective recruitment, selection, placement, development, maintenance, and utilization of the manpower resources of the entire organization 55 PERSONNEL PROGRAM ▸ It is consisting of series of activities intended to carry out the personnel policies of the laboratory for the purpose of realizing objectives of the organization. 1. Employment – consists of recruitment, interviewing, testing (psychological tests and skill testing), induction/on-boarding, promotion, placement, transfer of the workplace, rating, training, counseling, and separation of the employees 2. Safety – provisions for safety standard, mechanical safeguards, accident investigations, safety rules, safety 56 records, and statistics 3. Employee Relations – matters related to collective bargaining of the wage and salary, grievance system, medical and dental services, labor management relations, morale studies 4. Employee Research and Standards – includes job analysis, job description, job evaluation, job grading, wage analysis, organization planning, and employee manuals 5. Employee Services – recreational plans (team buildings, Christmas parties, summer outings), insurance plans, profit sharing plans, and other miscellaneous service 57 PERSONNEL POLICY ▸ It is the statement of intention that commits the laboratory manager to a general course of action in order to accomplish a specific purpose. 1. Recruitment, selection, and planning - It involves generating a pool of appropriate and qualified candidates for available job positions in the organization - It commences when the new recruits are identified and ends when the application from candidates are received 58 2. Employee induction and training The main objective of induction training are t provide new employees with information, tools, and direct experiences that will support them in developing their talents and also contribute to the growth of the organization 3 Employeeratingandpromotion - The step in the work measurement in which the analys observes the worker's performance and records a value representing that performance relative to the analyst's concept of standard performance. - Evaluating the employee’s performance as compared to different sets of numerical values or the standard sets by the rater - If that employee has a high or satisfactory rating, he or she can be qualified for a 59 promotion 4. Transfer, downgrading and lay-off - Transfer: the job rotations and transfers are lateral moves o He or she can move from one department to another without downgrading or upgrading the position or the job description of the employee - Demotion or downgrading: downward move o A step or a ladder lower the organizational chart or structure - Lay-off: the employees are out o Termination of the employees 60 5. Disciplining and Discharge - Written authority to give written reprimands, suspensions, or recommend discharges 6. Salary and Wage administration - Process by which wage and salary levels and structures are determined in the organizational settings 7. Changes in work assignment and hours - There are instances that we might need to extend our working hours (usually a case to case basis) - Those conditions are also stated inside the personnel policy 61 8. Services for employees ▸ - Provides assistance to the employees in a variety of ways to improve work and personal life ▸ - Example: medical, dental, insurance, and government mandated ser (SSS, philhealth, pag-ibig) 9. Employee's health and safety -OccupationalSafetyandHealt Administration (OSHA) ▸ - deals with all aspects of health and safety inside the workplace, and it ha ▸ a strong focus on primary prevention of hazards - Its goal is to prevent accidents and harm to people from work relate 62 activities ▸ 10. Employees' participation and work problems - In general, this is employee’s involvement in the organization - It refers to work systems that allow the employees to systematically give their input into decisions that affect their own work - This can be addressed through a series of meetings, evaluations, and feedbacks - Daily, weekly, or annual meeting 63 SOURCES OF RECRUITMENT INTERNAL SOURCES – are the employees actively working in the laboratory. ▸ oPresentemployees(Promotionsortransfers) ▸ oEmployeereferraloFormerEmployees(retiredorretrenchedemployees EXTERNAL SOURCES – include person who apply in person, who answer advertisement, and who are recommended by schools. Anything that is not related to those actively working employees ▸ oEmploymentagencies“outsource”(thirdpartypersonsorvendortoaidin their search) ▸ o Advertisements (most widely used method for generating applicants 64 LEADERSHIP 4.1 ORGANIZATIONAL FACTORS THAT INFLUENCE LEADERSHIP SUCCESS ▸ INTERNAL FACTORS Leadership – people in an organization that make all the major decisions regarding financing, budget, sales, marketing, and human resources o Organization having strong leadership have a clear vision for the future o They plan how to achieve their goals in a quantifiable way of measuring success o Develop the kind of management structure that enables employees to feel empowered while meeting production and sales goals Employees – managers must ensure that they are in constant communication with employees o Any problem of dissatisfaction within the rank-and-file (members of a group or organization who are not leaders) are handled in a timely manner o When employees feel valued and rewarded, they will go above beyond to maintain a high 66 organizational standard ▸ External Factors Customers/Clients – customers’ satisfaction is very important to the products and services Economy – business owners control the economy o They must respond to the indicators that trend upward or downward, and then they adjust their own operations accordingly o If the trend is going upward, the managers should reinforce specific rules or standards so that it will remain on top o If the trend is going downward, how can we now achieve the status to go upward 67 LIKERT FOUR (4) MANAGEMENT LEADERSHIP STYLES 1. EXPLOITATIVE AND AUTHORITATIVE ▸ It views the workers as tools and means of production without no further obligation to them ▸ The manager has no confidence or trust in their subordinates ▸ Subordinates feel that they have no freedom to discuss things about their jobs to their superiors 68 FOUR LEADERSHIP STYLES 2. BENEVOLENT AND AUTHORITATIVE/AUTOCRATIC ▸ They need only inform and direct their actions without seeking any feedback ▸ The manager has condescending confidence and trust in their subordinates ▸ There is motivation with rewards and some punishments 69 3. CONSULTATIVE ▸ Manager has substantial but not complete confidence and trust in their subordinates, but they still wish to keep control of the decisions ▸ Subordinates feel free to discuss things about their jobs with their superiors ▸ Manager gets ideas and opinions and 70 try to use them constructively 4. PARTICIPATIVE ▸ recognize Participative leaders employees' significant role in their organization's success. ▸ The input and responsibility for decision making process are list directly on the staff with only general guidance and oversight from the management 71 ▸ This involves the team approach END OF PRELIM COVERAGE :) 72

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