Healthcare Customer Satisfaction: More Talk AND More Action Customer satisfaction (Voice of the customer) is a recurrent th...
Saturday, February 21, 2015
Bill Troy asks an interesting question about the global nature of Quality, although I might argue the question could equally be framed in a number of other ways: “Does Quality have a national identity?” or “Is the world being well served by the global nature of Quality?” or “Can Quality become even more global in 2015?” or “Is there a global Quality community and what does it look like?”
Like most people I know who are involved in the Quality arena, Quality was something that I discovered long after my education and training. If I had any prior experiences they tended towards the negative images: “Quality means don’t use white-out, or don’t make scratch-outs when you write”. But I was lucky and the opportunities for initially an interest in Quality found me (rather than the reverse). Overtime that interest became passion and commitment in almost every aspect of my career.
As I moved along, I learned to appreciate that much of the modern Quality narrative is told from an early American perspective (Shewhart, Deming, Juran, Crosby, Feigenbaum) but almost as quickly the narrative takes on international focus through organizations like the Japanese Union of Science and Engineers (JUSE), and British Standards Institute (BSI) and International Organization for Standardization (ISO), and International Laboratory Accreditation Cooperation (ILAC) and the International Society for Quality in Healthcare (ISQua) and of course (waving my own national flag!) the Canadian Standards Association (CSA). So from the very get go, the international community as been on-board and very active with the Quality movement.
The last several decades has seen great strides in Quality adoption, especially in the arena of healthcare, and in my particular little part of that world, the medical laboratory. Through programs and initiatives including, but certainly not limited to World Health Organization, and the President’s Emergency Program for AIDS Relief, the landscape of laboratory Quality in many African countries has jumped forward through active programs in Quality Management (including the recently developed Strengthening Laboratory Management Toward Accreditation (SLMTA) initiative). And importantly one can point to the activities and leadership of my friend and colleague through the Saudi Quality Council.
In my own small way I get to participate in providing training in Quality Management for participants around the world on a near daily basis through our own university based course and through international training provision in Proficiency Testing. And hosting the UBC POLQM Medical Laboratory Quality Conference in October 28-30, 2015 (More on that later!!).
So that there is strong and active Global interest in Quality is not in question. But the larger questions of coordination of efforts that could lead to more effective integration is still an open topic.
Personally I see great hope for integration. First off, within the limitations and realities of resources, the message around the world is the Quality is Quality, and matters not who is the messenger.
As I get to move from meetings to conferences and on to international committees, I more and more see many of the same people, all working in a variety of roles surrounding Quality Partnerships. One day the topic is standards, the next quality management, and the next quality assessment or quality assurance. And all are involved in the arena of Quality Knowledge. What this means is that many of the barriers that have existed between Quality Partner groups are very much breaking down. The broad topics with Quality Partnerships are harmonizing.
And that is a good thing.
And if I have not made my point clear enough, let me be very specific. ASQ has been a leader in Quality for a very long time, and its broadening interests to the arena of International Quality can and will and does may Quality better.
Sunday, February 15, 2015
In the previous parts of this series I have addressed that education theorists have long ago determined that adult learners are different. When it comes to learning, the adage “adults are just big children” does not apply. Andragogy is the theory (science?) of mentoring adults is not the same as pedagogy (mentoring children). The challenge and message to us is that if we want to mentor our adult co-workers about Quality Management in the workplace then we are well advised to use the mentoring and teaching skills that work best for adults.
The problem is that most of us (a) are busy learning ourselves about quality (b) have never sought out training as teacher/mentors and (c) don’t know, indeed have probably never heard words like andragogy or pedagogy. The best we have to go on is our past experience as learners, which was unfortunately mostly during the time of our own childhood and adolescence which usually means standing in front of the group, usually with a PowerPoint file and drone on, point after point, for 40 minutes and then ask if anyone has any questions. And then wonder why most wander out, no questions asked, and usually no information absorbed.
Adults like to learn what they want, when they want, and are very specific in their expectations. Adults highly value their own experiences and usually like to share them, and importantly prefer learning by asking their own questions rather than by being pumped by others. And if it isn’t working they move on.
We also have another problem; many of us work in organizations like to talk about continuing education, but rarely like to support it with time or money or resources or even top management engagement.
So many of us step up to the plate with two strikes against us before we even get started; we don’t really know what we are supposed to do, and tend not to have the money or resources that we think we need.
So with that sort of an ugly start, let me share some ideas that will allow you to mentor Quality more effectively. That way when you do get some money, you can save it up for a bigger ticket item, like supporting a special speaker, or sending someone to a Quality conference, or perhaps subsidizing a person taking a course. Some of these come from Roberta Silfen’s book Teaching the Adult Learner; others are mine from my own experience.
First off, avoid the turn-offs. Forget the sign-in sheet. The notion of mandatory training is a crock. Mandatory education is something that kids get. And keeping “numbers of people taught” as a metric is a fool’s joke. The point is not how many bodies were there, it was how many brains you stimulated. If you really want to know how successful you were, try have a BRIEF post session satisfaction questionnaire.
And if you are putting on successful mentoring sessions, the audience will either coalesce into a small core of the focused and interested, or will grow.
Try an “open mike” session by giving people the opportunity to share their experiences on Quality. A person stands up and tells a Quality story, and then the audience can ask a few questions about it. In an hour you can get maybe 4 or 5 speakers. You get a chance to understand what your colleagues think about Quality. The Quality Manager can introduce the session and perhaps do a summary at the end and maybe start the questions off, but otherwise keep quiet. This is not your time to speak; it is your time to listen.
Try an interview session. Set up two chairs at the front of the room. You invite perhaps the laboratory director to participate, and have a Quality interview. What does Quality mean to them? Did they learn Quality through courses, or was it something that they learned to experience and osmosis? The point is not to pin them to the wall, or show off how smart you are or to throw in the gotcha question; the point is to give them the change to engage with the staff on why Quality is important for your laboratory. Staff might even get a chance to engage in some of the questions as well.
Try the journal club approach, where the Quality Manager finds a Quality oriented article or book (article is better) and share it with the group in advance. You might want to consider, for example, taking one or two blog entries or a current newspaper article, both of which might be ideal because they tend to be short. Someone presents the article and then gives their opinion which might range from “pearls” to “pin-cushion”, and then open the article to discussion where folks can relate to their own experience.
Try a lecture, but do it in an adult fashion. If you have 50 minutes for a session, don’t lecture for any more than 25. Appoint someone as the question person who can start off with two or three questions, and then open up to others.
The bottom line is always the same. Put out the information towards adult mentoring and learning strengths. Don’t hog the time. It is not about you. It is about exposing your adult staff to new ideas. Keep things moving, and allow your audience to get engaged, and participate and share.
So, what do you think?
Monday, February 2, 2015
If we believe that communicating Quality is the cornerstone to implementing and developing a Culture of Quality, then we have to accept that those responsible to doing that communicating know what to do. But with regret, that is what we call wishful thinking.
I am almost certain that most Quality leaders have little to no training in effective teaching/communicating, and rely mostly on their previous experiences as a student (when they learned mainly from people with little training). That, with regret sets us up for a potential problem.
So let’s look at this as a problem that needs to be solved. Most people come to Quality later in their career rather than sooner. It is an adult choice. Most of their experience has come from being a laboratorian, perhaps a technologist or a pathologist, maybe a nurse. But one thing is almost certain, few if any come to Laboratory Quality Management after being a teacher. Most of us have little training in public speaking, much less teaching. Indeed if there is any truth behind the stereotype of laboratory workers, many of us are not very comfortable in speaking in front of an audience.
The result of this incompatibility is that either we tend to do the prerequisite teaching not particularly well, or worse, we find all sorts of ways to avoid it, or not even raise it as an issue. And that is not good.
So there are a few things that we can do. The first thing actually is not learning about content; rather it is about learning how to talk. The content can wait. For those that get tongue tied or stress out at the thought of talking in front of a bunch of people, consider taking an adult public speaking course or participating in evening acting classes at a local community centre or joining Toastmasters, or start practicing at home with family or in safe social settings. Find a speaking coach. Approach this in the same way as you would learning how to drive, or how to operate a new analyzer. For most of us it won’t take long before we get the hang of it, maybe a month or two. But if you are not comfortable with standing on your feet and talking out loud to others, communicating Quality will be a painful process, both for you and your audience.
Another thing to do is look at andragogy (adult learning) and imbed some of the insights that others have garnered along the way. Some of the classic ones are to be found in part 1 [see: http://www.medicallaboratoryquality.com/2015/01/teaching-quality-spoiler-alert-it-is.html ]
More recently I have been scoping our more of the andragogy literature, and found another excellent author (Roberta Silfen – Teaching the Adult Learner – 2011).
Here are some things that Dr. Silfen brings to the table:
1: The Knowles principles are REALLY important. Perhaps most important is that adults view their past experiences as universal truths. They are very powerful and influence what they will gain from what they are learning today. Challenging those past experiences can only be done with caution. Adults want their past experiences to be respected and valued by others.
2: Given a choice between didactically presenting information and then asking if there are any questions, versus posing problem solving questions and then discussing the responses, adult learners prefer the latter.
3: Adults learn better at their own pace than at someone else’s pace. You have to be flexible.
4: Adults learning works best when teachers are comfortable in sometimes sitting back and letting others take the lead.
These can be really tough. For many of us (me, especially?) we love showing others what we know and love being the lead. For those of us like that (again me, especially) the title of Part one is really important (Spoiler alert – it is NOT about you).
To my mind, if building a Culture of Quality is important, then sharing the Quality message in a manner that invites your work colleagues to pick up the ideas to the point where they can apply them to their own work experience is absolutely critical. We have two choices; doing that messaging well or doing it not so well. One has a better chance of working than the other.
Next time (Part 3) I will address the question about to present information in a variety of cost efficient and cost effective techniques. Some are from my own experience, others are from Dr. Silfen.
PS: Dr. Silfen’s book Teaching the Adult Learner is available on Amazon.com for a truly under-valued cost.