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F-QM-008-B-V0 — Official Delegation of Duties, Authority & Leave Coverage Form

Type: Form · Version: V0 · Status: DRAFT — UNAPPROVED · Served read-only from the bundled QMS copies. The Drive master is untouched.

Parent document: LAB-QM-008 — Organization and Governance Policy (parent is encoded in the form number)

Rendered in-browser from the project's Word file F-QM-008-B-V0-official-delegation-of-authority-leave-coverage-form.docx (policies-docx / forms-docx — the file Junry reviews). Formatting is faithful, not pixel-perfect; the DOCX is the official copy.

Document #	F-QM-008-B-V0	Parent Document	LAB-QM-008 — Organization and Governance Policy

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Part 1 — Type of Delegation & Parties Involved

1.1 Delegation Category (Check One)

[ ] Temporary Absence / Leave Coverage: Covers routine duties during scheduled annual leave, sick leave, or official business travel.
[ ] Standing / Special Function Delegation: Assigns specific quality, safety, or section coordination duties to a designated staff member.

1.2 Parties to the Delegation

Field	Details
Delegating Authority:	Full Name: ____________________________________ Position: ________________________
Staff Member Assuming Duties:	Full Name: ____________________________________ Position: ________________________
Reason / Basis for Delegation:	[ ] Annual Leave [ ] Sick Leave [ ] Training/Official Business [ ] Special Technical Designation
Inclusive Effective Dates:	From: YYYY-MM-DD To: YYYY-MM-DD (or Ongoing until revoked)

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Part 2 — Specific Responsibilities and Authorities Delegated

Select all duties assigned to the staff member taking over:

[ ] Daily Bench Operations & Workflow Oversight: Coordination of daily specimen throughput and bench assignments.
[ ] Quality Control Review & Release: Verification of daily IQC runs and approval of analytical runs prior to patient testing.
[ ] Equipment Maintenance & Troubleshooting: Oversight of scheduled maintenance, calibration, and vendor service coordination.
[ ] Occurrence Intake & Immediate Containment: Logging occurrences and initiating immediate patient containment per LAB-QM-010.
[ ] Pre-Analytical & Phlebotomy Oversight: Direct oversight of specimen accessioning, rejection reviews, and outpatient phlebotomy.
[ ] Infection Control & Safety Monitoring: Conducting daily facility/safety checks and biosafety protocol enforcement.
[ ] Non-Technical Support Duties (Laboratory Aides only): Facility cleaning, temperature monitoring, supply receipt, and runner assistance.
[ ] Other Delegated Responsibilities (Specify): ____________________________________________________________________

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Part 3 — Boundaries, Limitations, and Non-Delegable Duties

Delegation Limits	Acknowledgment
1. Overall administrative and clinical accountability remains with the delegating authority and Pathologist per LAB-QM-008.	[✓] Understood
2. Final clinical pathology interpretations and medicolegal authorizations cannot be delegated to non-pathologist staff.	[✓] Understood
3. Laboratory Aides shall never perform, verify, or release technical clinical examinations.	[✓] Understood
4. Technical examination authorization requires active PRC medical technologist licensure.	[✓] Understood

Specific Operational Limitations / Exclusions: (Detail any specific functions or tests that cannot be executed during this coverage period): ____________________________________________________________________________________________________

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Part 4 — Acknowledgment and Authorization Sign-Off

Role	Name & Designation	Signature	Date
Delegating Authority:
Assuming Staff Member:
Chief Medical Technologist / LQM:	Junry, RMT
Pathologist / Head of Laboratory:
Hospital Director (if required):