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Sunday, February 2, 2014

Deming and the diversity of healthcare Quality



Deming and the diversity of healthcare Quality


I am going through a personal evolution in my Quality career.  It is starting to get very complicated.  

In many ways I am very typical of people of my age and era in that given the opportunity to get involved, my first instinct is always to say “Yes!  Part of this reflects my personal interest in the Quality process, part of it my ego that still leads me to believe that I can do everything and do it all very well.  And part of it is a protection strategy; given a choice between having to deal with a standard that someone else has written and having the opportunity to inject my own beliefs, I would rather fight the battle early rather than fight it late.  This strategy has stood me more in good stead than bad over the years, although it does take a certain toll on my time.

But as I get closer to thinking about going to the next phase, I do reflect on what I do and what it says about Quality.  The reality is that most of what I do is done on a volunteer or a small honorarium basis.  Most of it does not generate direct revenue.  Most of it exists because I have a position that provides me with an income base and a fair amount of flexible time.  It all keeps me very busy, but not of it is “busy work”.
As far as income generating activities, I have a faculty position at a university and as part of that position I operate a proficiency testing program that works across Canada and provides international training to personnel in developing countries so that they can learn how to develop similar PT programs in their own country.  I also teach an on-line course in medical laboratory Quality.  Both these activities   can take a lot of time.  I have learned that a program or a course that stands still and rests of success and laurels is a dead program or course, soon to become very obsolete and mowed over by competition.  Operating both of these activities has allowed me to develop and hone my innovation chops in order to stay one step ahead, or at least not two steps behind.   

But in order to support these two programs I have become directly involved with a variety of Quality Partner activities, primarily in the standards development and the educator/communicator arenas.  I sit on a variety of standards development technical committees on both the national and international level, in part developing documents which my programs are intimately involved with.  In my opinion I know of no better way of knowing exactly what and why a standard requires certain expectations than being involved in the writing.  

I also get a lot of opportunities to get involved in networking through education/communicator process.  Over the years we have trained and certified near 300 people as medical laboratory quality managers, many of whom have remained in contact, and some have remained close.  We regularly put on Quality oriented conferences which brings me together with the former group and creates connections with new and interesting speakers.  Of interest we are now in the planning phase for our next conference which will occur next year, and I have already got a collection of speakers who will be new and unique to our audience community.  

In addition I have just finished one book chapter and I have been asked to write a new book as part of a series focused on medical laboratory Quality and patient safety which will create potentially a broader audience for  the conference.   

And next week I get to travel internationally to a meeting on Excellence in Medical Laboratory Quality and give a presentation which likely will help foster both meeting attenders and course takers.   


My point is not to blow my own horn about how busy I am (well maybe a little bit), but rather to make a few points: 


  1. First and foremost the arena of medical laboratory Quality is very alive and very busy.  If you are bored with what you are doing, you aren’t trying.
  2. Second, if you want to have success in this arena you have to keep new and fresh and diversified but with clear links to your foundational base.   

And lest you miss the point, all of this is totally consistent with Deming and 5 of his 14 absolutes:

  • Create constancy of purpose for improving products and services.
  • Improve constantly and forever every process for planning, production and service.
  • Adopt and institute leadership.
  • Institute a vigorous program of education and self-improvement for everyone.
  • Put everybody in the company to work accomplishing the transformation.

I always have thought that if W.E.D. had taken the opportunity to adapt his list of absolutes he would have included “Plan for success by getting busy and staying busy”.

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