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Thursday, June 7, 2012

Measuring Quality Knowledge

People grasp information in many ways.  They may observe, or perceive, or even describe information, but it can be argued that they do not really know the information until they can integrate facts from their past to use in the present or in the future.  The process of discovery is taking information from many observations and sources and integrating it into novel concepts.  It is the aspiration of teaching that people not only learn facts but discover how to integrate them for broader application and insight; the creation of “new knowledge”.

It was with this in mind that on the final examination for our Certification for Laboratory Quality Management course I asked the following:  Phillip Crosby defined Quality as “meeting requirements”.  Explain what is meant by the phrase “meeting requirements”.  Provide examples of meeting requirements as they might apply to (a) laboratory turnaround times, (b) laboratory accreditation, and (c) writing of standard operating procedures (SOPs).

OK, maybe it wasn’t the best question to put on a final examination, but there was a lot of choice and answering this was not compulsory.  That is probably why there were so few takers.  What I wanted to see was some evidence of information integration happening.  

When it comes laboratory turnaround times, this is pretty straight forward.  A laboratory has choices.  It can perform and complete analysis at its own convenience (how often do we hear that complaint!) or we can take into consideration the needs of the clinician and patient.  We can arbitrarily set time limits such as 1 hour or 1 shift or 1 day, and then measure how often we meet that goal.  Or we can go a talk to the clinicians and understand what their needs are.  Do they usually need the information the next the same day, the next day or the next week?  Does getting the information to them too late cause problems?  Does getting the information out very early create other problems?  

Having gone through the exercise we can say that we understand better the needs of our clients, and then develop strategies that will help us meet those needs.  That approach integrates “meeting requirements” and “turnaround times”. 

In a related way, if you write a Standard Operating Procedure (SOP) and nobody can read it or understand it, does it actually exist?  Well it may exist but it certainly doesn’t meet the criteria for being a Quality document.  It does not meet the requirements of your main internal customers, ie the people that work with and for you.  SOP developers should always take the opportunity to have their documents reviewed by the personnel before it gets finalized and integrated and signed off into the document control process.  Does it meet the needs of clarity and specificity and achievability?  Does it make sense to the people that are going to implement it?  If it does that’s great; that’s called “meeting requirements” and it becomes a useful Quality document.  If it does not, they we call that an “opportunity for improvement”.  

Integrative knowledge questions are a common part of the examination process, whether it is done in form of long or short paragraph or in multiple choice.  A recent paper by Stuart H. Jones and Michael Wright (University of Calgary) – “Does Cognitive Style Affect Performance on Accounting Examination Questions?”  in Global Perspectives on Accounting Education Volume 9, 2012 describes the ability to organize information either as being field dependent (ability to organize familiar structured information) versus field independent (able to organize information that is less familiar and more complex).  Field dependent students (FD) performed the same as field independent (FI) ones on straight forward examination questions, but did not perform as well as the FI students on questions that required more information integration.  FI students would not only tend to do better on this style of question, but that does not mean they would be more likely to choose complex questions. 

When researchers looked at the total group, neither age nor gender is strongly linked although men tend to do better than women and older children tend to do better than younger children or adults.  Furthermore FI people’s brains tend to work differently in that if given a complicated picture, they are  more able to see embedded figures and shapes inside the picture using a test called the Group Embedded Figure Test or GEFT. 

To date the cognitive style research papers that I have found have tended to be focused on individual groups and do not give any information about the proportion of FI people there are in the general population, but in the absence of any information to the contrary I am going to make the claim that people interested in Quality are by definition very bright, very intuitive, and very field independent.  Our collective Quality-oriented brains are just better wired.  But given a choice, we, as with our FD colleagues, do not tend to select more challenging questions when less complex ones are available.

By the way, you might notice that the examination question asked for 3 examples, one on the application of “meeting requirements” in the context of turnaround times, and another in the context of writing SOPs and the third in the context of laboratory accreditation.  For purpose of this entry, I purposely left that one unaddressed.  

I would be interested in knowing if anyone in the context of anonymity (or not) wants to take a shot at this one.  

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