I have been asked to develope competencies here as well.  Our old competencies were too minimal.  The suggestions I have been given are to have a checklist of bare minumum requirements.  For instince I have a minumum of 40 blocks face and cut in 2 hours (we divide our blocks into 40 block trays so it is a convenient number to use).  Unless you have really bad blocks or many multiple level blocks any of my techs can do this, even my trainees.  

Then, I will have them submit an extra slide of a few different tissue types.  I will record the quality and file it away wit their name and date as proof that they can cut this year.  I will also have them stain an extra control of a few representitive Special Stains and Immuno's.  I will record the quality and file them with the tech's name and date to prove they could do those stains.

Note that I do not have this in place yet, these are my ideas after speaking with my lab manager.  I think Competency should be a basic level of can the tech produce slides that are accurate for diagnosis?  If the answer is yes, then they are competent.  The superviser just needs to document that the tech is capable of producing accurate work so that an outside agency can look at the records and see that competent people work in this lab.

I have handled productivity in a different way.  I have a goal 40% of our slides out at 7:30am ( I have a good night shift), and all slides out by 12:30pm.  I have found that my crew responds well to the challange of seeing improvements in the statistics.  I challange them and they challange themselves to get better.   People don't have to be told that when they are rotated to a certain bench TAT goes down.  The stats are posted, and they see the results and strive to improve.  The Pathologists also love to see the stats improve.  When we have setbacks, we try to find out what went wrong that day.  Also, if I see that we are running behind, I jump in the lab and help out.  (this is the first day in 2 weeks that I have seen my office before noon).

I will be the first to say that this approach will not work with every lab.  While I have worked here we have had some real problem people, and I feel lucky that I wasn't superviser then.  I have a good group and I work hard to cultivate good morale.  For instince I take a lot of heat from management for letting people go to eat together, sometimes the whole histo lab goes if everyone is at a stopping point at the same time.  Someone (usually me) stays to sign out slides and answer the phone.  I have found that if the folks eat together they work better together.  If you are friends, you want to work hard so your friend doesn't have to shoulder your load.  

I have accually helped improve a tech who wasn't performing as well by ensuring the person went to eat and sat with the other techs.  So much of histology is teamwork, and though the person produced good work this person wasn't percieved to help others and so they didn't help the person either.  There has been a vast improvement in the past year, and this helps the entire lab's productivity.  People here used to waste too much time talking about how someone else isn't doing the work they are.  Productivity needs to be a total lab thing.  

If you have some real dead weight, then I really am sorry.  I have heard some horror stories about a few government labs.  Someone else may be able to offer some tips about documenting problems for eventual termination.

Ross Stapf
Washington Adventist Hospital