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Healthcare Customer Satisfaction: More Talk AND More Action

Healthcare Customer Satisfaction: More Talk AND More Action Customer satisfaction (Voice of the customer) is a recurrent th...

Monday, July 30, 2018

Sharing knowledge for better laboratories.


As I move more actively towards my retirement from my university career, I find myself thinking about what I have enjoyed doing the most under the university banner.   

One of my most significant mentors talked regularly about university activity as being like a  three-legged chair; with the legs being education, research and outreach.  At its best, university life is inherently unstable, but if one is active in all three aspects, the chair can remain intact, but if one of the three legs is ignored or broken, the whole university experience will assuredly falls apart.  I have always seen the wisdom in this and have spent my career ensuring that I am engaged in all three, to the extent possible, all the time.   

For me, I think the piece that I have always enjoyed the most has been outreach both inside and outside the university confines. 
  
Putting on conferences and workshops is a big part of outreach and education.  Attending conferences is a big part of education and research because conferences and workshops can be the cornerstone of new ideas and new knowledge.  Combining the two becomes a triple-win experience.



So this October 23 we will be continuing with our tradition of October Quality Conferences, on the theme: Medical Laboratory Quality Improvement: Knowing Your Customers. 

This may seem to be a unusual theme for a department of pathology but for Laboratory Medicine knowing and understanding who is your customer is vitally important.   

Over the past two decades healthcare has put the banner on the wall “We are Committed to Patient-Centred Care” but for too many these are only words.  Listening and discussing with those who have actually attached actions to the words is a day well spend.  

So we will be talking about technology assisted satisfaction monitoring, and hearing from laboratories that have moved from theory to practice.   We will be hearing about Kano and Service Excellence and how this can be applied as another step forward in improvement.  

There are a few spots not yet finalized.  If you have some thoughts let me know.  I don't promise paying your way to Vancouver to attend and present, but I can guarantee we will listen. 

This is not our first Quality Conference, but we will be trying out something new (for us).  
Coming to Vancouver in the age of expensive airfares and cities with choking street congestion can be difficult to justify, even if there is a really interesting show to see.  So this year we are planning to provide streaming video for those unable to physically attend. It will not provide all the same experiences with full and open dialogue, but you will still be a part of the experience.

For those interested, keep your eye on: http://polqm.med.ubc.ca/2018-polqm-conference/ or better still go there now and register at the early-bird rate.


Monday, June 11, 2018

Happy World Accreditation Day 2018


We all have our special days.  

For many (most?) we celebrate cultural/social/religious events like Christmas, or Ramadan, or Rosh Hashana, or Mother's Day.  For others there are national birthdays, and for others they are just a good excuse to have a good time (April 20th) or better still, a long week-end if possible at least one a month.   

But there are others, let's call them occupation-recognition days that usually come up as a moment to remind ourselves (and others) that what we do is important.  I’m thinking about National Secretaries’ day, or International Nurses’ Day, or Doctors’ Day, or International Accountants Day, and even National Be Kind to your Lawyers’ Day.

So we should not be too surprised that there is a some days for Qualitists and Qualitologists to celebrate Quality.   Actually we have three days including (a) International Standards Day (October 14th) which celebrates the day that ISO was founded (which happens to also be Deming’s Birthday), and World Quality Day (the second Thursday in November) which was pronounced by the Chartered Quality Institute (CQI) in (I think) 2008.  
 The third is World Accreditation Day which was founded jointly by the International Accreditation Forum (IAF) and the International Laboratory Accreditation Cooperation (ILAC) to fall on each June 9th starting also in 2008.  

I am not sure why there are three different days to celebrate Quality especially when Quality, Standards, and Accreditation are so intimately linked, but what-the-hey, each can become its own reason and recognition for partying and celebration and a congratulatory pat on the back.

In our certificate course we talk about Quality Partners as those bodies that exist to help medical laboratories enhance their own quality, and we include Standards Development Bodies and Accreditation Bodies as two of the essential partner groups.  So it is relevant and appropriate that I remind our participants of their special days.
The others are PT/EQA, educators, suppliers, and professional bodies, which reminds me that we should tack on to our celebration calendar October 5 (World Teachers’ Day) and May 15 (Suppliers’ Day).

So for those who plan to celebrate World Accreditation Day today (I see that Standards Council of Canada is have a big “do” today) this is a time for congratulations.  I’ll wait a few days before I re-raise the persistent and annoying disconnect the exists between Accreditation and Quality Improvement.  

And since it I can’t seem to find any reference anywhere for a Work Proficiency Testing / External Quality Assurance Day (World PT/EQA Day) I think I will make its creation and recognition as my new mission.

Thursday, May 31, 2018

The Culture Quality Interface


The Culture Quality interface

Culture and Quality has been a long-time interest of mine.  I have stated with total certainty that an organization needs to have a palpable Culture of Quality in order to succeed in Quality Improvement. 

I still believe that to be an absolute truth, although I have moved a little bit from the absoluteness of the statement.  Today I am more comfortable with the saying that having a Culture that supports Quality may or may not lead to significant improvements in Quality Improvement, but if the acceptance and interest in Quality is NOT there (i.e. if there is no Culture of Quality) there is absolutely no chance to creating any lasting Quality Improvements.  

Said another way, even if everyone sees the value and importance of Quality, improvements may not last because financial, or changing dynamics, or other interferences get in the way.  But with absolute certainty, if no one in the organization gives a damn, the likelihood of improvement is not only zero, the greatest expectation will be that more errors will occur, staff will be more indifferent and whatever level of Quality there is, will get worse.  It is stunning how often we see that in action. 

So understanding Culture is essential and integral to implementing Quality Improvement.  

With that in mind, the last few days have been really enlightening for me because I was able to change out of my teaching and investigation mode and became a student by taking a course in culture improvement.  The centerpiece of the course was exploring the Organizational Culture Assessment Instrument (OCAI) which can be used to define and characterize the competing values of culture types.

The course was given by Marcella Bremer who lives in The Netherlands and is a major player in the international community of Culture improvement. 

The course was just what I needed; away from the office and intrusions for 3 days and the opportunity to focus.   Most participants were consultants from across 5 continents wanting to explore and dabble in OCAI.  I also met a kindred spirit; a person working in another university setting and struggling with all the same issues that I also have to deal with, and maybe worse.  

Without going into too much detail, the developers of OCAI were deeply interested in the nature and personality of organizations (all organizations) and studied many cultural characteristics.  Through comparative analysis, they were able to weed down to 4 major personality influencers and types: 

Hierarchy
the processes that bring order and CONTROL to an organization such as standards and guidelines, top down management, process and procedure, quality control, accreditation etc.

Clan
The processes that bring collective COOPERATION to an organization such as staff engagement, kaizen, etc.

Adhocracy
The processes that bring CREATION to an organization such as research and development, new programs, new methods, new strategies, etc.

Market
The processes that lead to COMPETITION such as methods that increase market share such as market strategy, market growth, customer satisfaction.  (note:  in healthcare, there are elements of competition that exist such as wanting to find more patients, or more studies or more grants, but mostly what we are try to focus on is more and better satisfaction).

What is, or should be intuitively obvious, is that each of these elements is essential and the choice is not one of exclusion, but of balance.  Sometimes an organization’s improvement needs a little more top-down support.  Other times the opposite may be what needs to happen.

We spent little time talking abut the OCAI itself (it is after all only one management tool), and much more on what organizations can do if they believe there is room for culture adjustment and how the information within OCAI results can give some guidance.  What is pretty clear, is that (a) it is not as easy as snapping your fingers and (b) it can be a lot more straight forward and not as hopeless that you fear it might be.  I left with some definite ideas how I could make things happen.  

For me, this time away from the office was a total success; what could be better than getting to spend 3 days with people pretty much of like mind exploring new thoughts and new ideas.  

But as I said at the beginning, strengthening a laboratory’s collective culture and interest in Quality Improvement does not guarantee there will be success.  But doing nothing will assure that improvement efforts will not lead to success, and more importantly, will either remain static, or slide down the pipe to more error and failure. 
 
What a choice!!