Monday, August 15, 2011

Managing Management Review.

CMPT is in it annual report season which means it is time for my doing my annual Management Review.  Over the years I have learned to enjoy the process.  
In many respects it is like eating olives or drinking coffee; the first time you to do one it is not particularly pleasant, but over time they all become an “acquired taste” and they actually become better than “not bad”. 

I recognize that my career path is probably a little different from others because I spend a lot of time in and around some of the intricacies of Quality, and so I regularly look at the management review requirements in a variety of documents including ISO 9001:2008 (Quality Systems), ISO 17025:2005 (Calibration and Testing Laboratories), ISO 15189:2007 (Medical Laboratories) and ISO 17043:2010 (Proficiency Testing Providers).

All of them have a lot in common. 
All of them in one way or another speak to reviewing existing policies and procedures, the results of audits and assessments (both internal and external), customer feedback, comments and complaints, and the processes of finding non-conformities or opportunities for improvement and ensuring that the appropriate corrective  and preventive actions have been undertaken. 

There are a few differences too.  15189 addresses a few additional issues, such as monitoring turnaround time (boo-hiss. Whatawasta time!) and reviewing an evaluation of suppliers (This is a good idea that should exist in all the other review requirements.) and the review of quality indicators for monitoring the laboratory’s contribution to patient care.  I personally think this is a good idea, but an example of really poor writing.  I think this is about readability and relevancy of reports, and maybe about test menus.  But neither of these are issues one would or could follow with an indicator.   

9001 offers some additional elements as well that contribute greatly to quality, including in the laboratory.  And laboratorians would be well advised to supplement their assessment with some or all of these because they help keep the quality system on track and current.   There is an expectation to review the organizational structure.  Laboratorians have learned all too well about the impacts of organizational change, including both the positive and the negative aspects.  You want your workers to follow the policies and procedures set for your laboratory.  They likely will be unaware of organizational changes that have a direct effect on those policies and procedures.  If you don’t make the required adjustments, don’t be too surprised when problems result.  This year in my review there were six policies that needed updating to adjust for changes that have occurred over the last year.

And let me take this one step further.  As the change management folks are fond of saying, the only constant in the medical laboratory is change.  Programs and patient care issues come and go on an irregularly irregular basis.  One day there is a haemodialysis program, the next day it is gone.  One day there is a leukemia ward, and then it is moved to another facility.   A new patient care initiative is dropped in.  Suddenly there is a new and urgent demand for three new tests.  If management does not keep these issues in mind, then meaningful strategic planning is impossible.  At least the annual management review process creates the opportunity to bring these issues to front-of-mind and to make some stabs at learning from what happened last year, and planning for next year. 
So management review is not only a nice thing to do, it provides management with the tools to make good forward thinking plans and decisions.  
Remember when management review in the medical laboratory only meant making sure that the standard operating procedures had a current date and signature. 

Pass the olives please.


  1. community members who go through the auditing process–which can be anxiety inducing–but you make a great point about how strong systems and dedication to continuous improvement are what management systems are all about. Thanks for sharing.
    iso 9000

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