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Wednesday, November 7, 2012

Confabbing again in 2012



There are a number of meetings where qualitologists can get together and learn.  Some of them focus on proficiency, some focus on patient safety, and some are generally unfocused.  But clearly and without doubt the leader in quality oriented meetings is the Lab Quality Confab held annually for the last 6 years by Robert Michel the editor and driving force behind the Dark Report.   Not surprisingly, the majority discussion is framed around Quality from the perspective of the US health laboratory, but of interest to me is how many people make the trek from across Canada to attend the Confab.  Even if our health administrative structures are different, the Quality and Leadership themes of the meeting find accord on both sides of the border.  What surprises me is the absence of representation from Australia, Asia, and, Europe and Mexico.  

Robert Michel is highly connected to the Quality community, and brings together the prime movers and shakers for 2-3 days to talk, think, and learn about Lean, Six Sigma, Leadership, Innovation and Improvement with particular reference to the medical laboratory.  His speaker invitation list regularly includes leaders like Richard Zarbo from the Henry Ford Health System in Michigan and Rick Panning now of Fairview Health Services in Minnesota and Stephen Raab from Eastern Health in Newfoundland.  

The meeting was opened by Michel talking about the new report by the Institute of Medicine entitled  Best Care at Lower Cost: The Path to Continuously Learning Health Care in America which highlights the value and importance and opportunities for implementing Lean and Six Sigma as tools to result in better handling of information and process in order to result in better effectiveness and productivity as the same time as lower error rates and more effective cost savings.  There is no doubt the squeeze is on, as the report makes the point that over the last decade, “a 30% increase in personal income over the past decade effectively eliminated by a 76% increase in health care costs”.  Clearly this is an unsustainable trend that will be addressed, either by healthcare or by politicians. 

Consistent with the message, Richard Zarbo pointed out how with effort and foresight and application of Lean principles, anatomic pathology can, and indeed must, revamp itself and result in faster more effective workflow with improved performance and huge savings in turnaround time.

ISO 15189 is continuing  to take hold in the US with now near 24 laboratories being accredited on a volunteer and supplementary basis.  K. McCloy from LabCorp gave a compelling presentation on her experience as 5 Labcorp sites underwent the 15189 experience.  No this is not for every laboratory, but clearly that go through the exercise clearly come out the other end is better shape that when they went in. 

One of the scariest presentations was given by Nora Hess talking about a laboratory (named in the presentation, but not shared here) got caught in an administrative nightmare when they were reported for having send part of a PT sample to another laboratory, not for malicious reasons, but because because some workers overinterpreted the PT provider's rules about handling PT samples consistent with how a laboratory handles their routine samples.  In a very scary fashion, the US process treated a minor "transgression" with a sledge hammer, way out of proportion to the "crime".  What is important is that if the PT scheme had used a CMPT approach, the whole problem would have gone away.

I gave a presentation on proficiency testing based on our CMPT experience and talked about the huge benefits and advantages that stem from smaller boutique programs that use simulated samples.  Not everyone agreed with me, but afterwards I was pleased by the questions and discussions that followed.  Clearly there are some appreciate that our approach has value.  

Clearly not all presentation were pearls, but all-in-all this is a great meeting that meets all my needs: an excellent meeting in a good venue with tons of stimulating thought and activity.   I cannot ask for more.

I am energized.

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