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Action Plans

Learn how specific problem-solving plans can be a blueprint for success in the clinical laboratory.

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Your laboratory has problems. It may be a personnel shortage, a problem employee, an analyzer on its last legs, a computer implementation or all of the above. Despite staff agreement that "something" needs to be done, looming large is their resistance to anything you might do to try and fix problems. You need a blueprint for success to get from A to Z, building teamwork as you go. Fortunately, simple action plans can do just that

Problem Solving 

First, define the problem. Cognitive psychology describes two general types: well-defined and ill-defined.1,2

Well-defined problems can be solved using algorithmic or heuristic methods, depending if the situation is known or novel. An algorithmic approach uses a set of steps that almost always solves the problem, e.g. using Westgard rules to resolve quality control shifts, trends and outliers. A heuristic approach applies generic rules to a new or unique problem, for which an exact solution is unknown, e.g., instrument failure.

Ill-defined problems are, unsurprisingly, harder to solve. Problems that require insight, creativity or thinking "outside the box" all fall into this category; they are also those problems that either seem impossible or are resistant to heuristic approaches. An example in your laboratory might be recruiting staff for a third shift; a creative solution may involve short term staffing plans and long term partnerships with local schools.

Ill-defined problems, however, often can be broken into several well-defined problems. Indeed, business guru Peter Drucker defined four problem types, only one of which is unique: truly generic, truly unique, generic (but unique for the situation), and new generic problem.3 If, as Drucker suggests, unique problems are truly rare, then as a manager you can adapt action plans to solve everything else.

The Action Plan

A structured approach to problem solving avoids decision paralysis and backtracking that wastes time. This involves at least four steps:4

  • Define the problem by writing it down. Writing down what you want to achieve helps make sure you have the right problem and to stay focused on it. This often involves a root cause analysis.
  • Generate solutions. Solutions can be generated by a number of creative techniques, such as brainstorming. A common mistake is to select the first solution that might work; it's important to generate a number of them.
  • Evaluate and choose a solution. Generating alternative solutions lets you test them against each other and choose a likely "best fit" considering impact, acceptance, ease of implementation, and organizational support.
  • Implement and Follow-up. This should involve others in selling and making the change. Don't forget a feedback mechanism to make sure the problem is fixed.

Awareness of defined versus ill-defined problems and their possible solutions helps you parse a large problem into smaller, easier to handle sub-problems, which you can delegate to others. To ensure success, at each step involve as many people as necessary to identify, brainstorm, evaluate and plan. This fixes the problem quicker and is great teamwork, too.

Creating an Action Plan

Now that you've identified the problem and chosen a best solution, it's time to write the steps to get there. If your goal is a vacation at Yosemite and the solution is to rent a car to get there, for example, your action plan describes where you rent the car, what route you take, how much money you need, who goes with you and so on. Don't forget to take pictures when you get there (feedback mechanism). An action plan isn't a "to do" list of things that need to be done but an itinerary of what will be done.

Sample Action Plan

Problem  
Solution  
Team Members  

 

Action
Team Member(s)
Additional Resources
Possible Barriers
Deadline
         
         
         

To complete your action plan, write down the tasks to be done in order. Include other headings in your template as suggested in the Table, which shows a few basic elements of any action plan: 

Problem: This is your problem goal statement as originally defined, and one of the reasons it's important to follow a structured problem-solving process.

  • Solution: This is the solution chosen above, also an expected outcome.
  • Team members: These are people involved in the process with a stake in the outcome; they are people most likely to carry out the tasks.
  • Action: These are the single tasks to accomplish (first step, second step, etc.) and may need to be prioritized by dependence or availability of resources.
  • Team member(s): The person or people responsible for completing the task. This is where teamwork shines as members volunteer, take assignments, or suggest other members for your team.
  • Additional resources: A broad category that includes other people, goods, equipment, services, etc. to get the task done.
  • Possible barriers: This is an optional but important category to give the team a heads up about problems that may be encountered.
  • Deadline: This can be used for accountability of team members or to help prioritize tasks, i.e., "A" has to be completed before "B." It also gives an overall sense of completion of the project.

Different mnemonics can help keep you on track. Your goal should be SMART (Specific, Measurable, Attainable, Realistic, Timely); one business expert says to steer clear of BHAGs (Big, Hairy, Audacious, Goals).5 One management site recommends double checking your plan with SCHEMES (Space, Cash, Helpers, Equipment, Materials, Expertise, Systems) to make sure you don't leave anything out.6

Blueprint for Success

Your action plan is a living document to share, update and revise with team members. Just writing it down guarantees success in completing many tasks and gives your team a sense of what, who, and when. It may be useful to add other categories to your plan, such as Priority, if they need not be completed in order; group techniques such as rank ordering are useful.

Action plans aren't just a blueprint for success; they are the secret to attaining goals. Once you start building and using them, you can implement real solutions for real results. This helps your team solve problems and improve patient care.

Scott Warner is lab manager at Penobscot Valley Hospital in Lincoln, ME.

References

1.      Wikipedia. Cognitive psychology and cognitive neuroscience/problem solving from an evolutionary perspective. Available at: http://en.wikibooks.org/wiki/Cognitive_Psychology_and_Cognitive_Neuroscience
/Problem_Solving_from_an_Evolutionary_Perspective#Introduction. Last accessed: 4/12/11.

2.      Carnegie Mellon. Problem solving. Available at: http://www.andrew.cmu.edu/course/85-211b/Problem-solving.html. Last accessed: 4/12/11.

3.      Sources of Insight. 4 types of problems. Available at: http://sourcesofinsight.com/2008/12/03/4-types-of-problems/. Last accessed: 4/13/11.

4.      American Society for Quality. Problem solving. Available at: http://asq.org/learn-about-quality/problem-solving/overview/overview.html. Last accessed: 4/13/11.

5.      Silverstein R. Create an action plan now. Available at: http://www.entrepreneur.com/management/leadership/article201888.html. Last accessed: 4/14/11.

6.      Mindtools. Action plans. Available at: http://www.mindtools.com/pages/article/newHTE_04.htm. Last accessed: 4/14/11.

 




     

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