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Wednesday, April 17, 2013

Twelve Core Quality Messages in Plain Language

Twelve Core Quality Messages in Plain Language

Over the last while in this blog I have raised the challenge to medical laboratorians that it is time to start changing our report writing style.  

 In the past our reports have been written by us, and by-and-large not with the customer in mind, but rather to suit ourselves.  As much as we like to lay the fault with the Laboratory Information System (LIS), we were the ones that picked the words and style. We are all to blame, but I would argue that the two most guilty have been the tissue pathologists and especially microbiologists.  

 In microbiology our reports are so full of jargon and subtlety that I am surprised that anyone can figure out what we are saying.  We insert microbial name changes at the drop of a hat, we use terms like “GAS” and “GBS” and “no anaerobes detected” and “no significant growth” and “normal flora” as if everyone understands what they mean.  Newsflash.  Few physicians and virtually no every day patients have a clue what any of those terms mean and creating reports with those terms is not helpful.

But if that is a problem, pity the poor person trying to get a grasp of Quality without taking a course.  Our area of interest is so loaded with jargon and gibberish I suspect that most of us have at best only partial understanding.  Agile, scrum masters, waterfalls, kanban, poke yoke, green belts, black belts, DMAIC, scorecards and OFIs; it goes on and on.  If we want to develop a consistent concept of Quality, then perhaps we need to start developing a more direct, interpretable language that can be understood as clear language.  [For related reading see:  http://www.medicallaboratoryquality.com/2011/09/quality-and-tower-of-babel.html ]

Consistent with that message, recently I was to prepare a lecture for some students that have an interest in international public health, but have essentially no laboratory contact and even less contact with the concepts of Quality Management.  A tough exercise at the best of times, but to provide the information and immerse them in Quality terminology would be a mind numbing, eye-glazing, nap promoting experience.  I have endured those lectures before.  Stone cold killers.

So this gave me an opportunity to see if I could create a lecture in a way that would allow them to at least grasp the concepts of Quality and remain if not alert, at least conscious.  I figure if I can get the concepts across in plain understandable terms I can make Quality relevant.    At a later time, for those who might develop an interest to discover more, we can start to introduce the specific terms.

To that end I created the following, which I think covers the main messages that we think about when we decide to implement a Quality system.  Each message is connected to a specific Quality Process.

I call the following:
Twelve Core Quality Messages

        Quality is everybody’s business, but  Management carries
80 percent of the load
(MANAGEMENT RESPONSIBILITY)
        Employees need to know what you believe
(POLICY DEVELOPMENT)
        Employees deserve  to know what their job is
(JOB DESCRIPTION)
        If performance is not right, it is wrong
(QUALITY CONTROL)
        Everyone should read off the same page
(DOCUMENT CONTROL)
        Think before you Do;  Check and Fix what you Did
(PDSA)
        The earlier you detect mistakes the better
(CORRECTIVE ACTION)
        The error you prevent is no longer an error
(PREVENTIVE ACTION)
        Learn from your mistakes
(OFI and CONTINUAL IMPROVEMENT)
        A second look is very helpful
(INTERNAL AUDIT)
        An outside look is better
(EXTERNAL QUALITY ASSESSMENT)
        If Management doesn’t check, then it doesn’t know
(MANAGEMENT REVIEW)

Maybe I am deluding myself, but I think this is something that I can use, and might work.
Fingers crossed.

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