Sunday, July 14, 2013

The Customer you do not have.

The Customer you do not have.

This is an interesting time for me in the Quality arena.  In addition to focusing on my programs and activities including CMPT our proficiency testing program and our POLQM course and conference I continue to be very engaged in standards development in particular with ISO and the Canadian Standards Association (CSA).  The more that I do, the more I find that all these activities interact and evolve together.   Recently that interaction and evolution has become very active in the collective areas of requirements and satisfaction and risk and innovation.  

ISO 9001 has started towards its new iteration for :2015(?) which will see some key changes with respect to the significance of products and services, and variations with respect to quality management principles, but it seems to me it will still address the business customer from the sense of meeting needs, ensuring satisfaction, monitoring complaints, and investigating error. All of these are important because businesses survive on repeat customers who have to be satisfied customers.  I understand this and it makes sense to me.  It is all consistent with the 4 absolutes as iterated by Phillip Crosby way back when.

The same message is carried in the two laboratory oriented documents ISO/IEC 17025:2005 (!) for testing and calibration laboratories and ISO 15189 for medical laboratories.  These two documents address satisfaction and customer needs although not to the same degree or sophistication as ISO9001.  ISO 15189 really only addresses the needs of one of its customer groups (the test ordering, report receiving, report interpreting clinicians) but is not as thorough when it comes to the other critical customer – the patients.
But the point that I want to make is that all these documents are viewing their customers from a singular point of view, the customer that they have now.  While the customer they have now is important, the reality is the businesses cannot survive for the long run if they only consider the customers they have now.  They also have to think about the new customer that they want.  The new customer that they want is the source of growth and opportunity.  The new customer they want is the inspiration for innovation and for positive risk. 
[Most risk documents define risk in the sense of negative risk through uncertainty, making decisions in the absence of thorough information which may result in the bad things happening.  Positive risk is the recognition that decisions can result in good things happening.  More on this later.]
My experience is that innovation is not a domain in which most laboratorians are particularly focused, in large part because the needs and pressures are innovative change are muted.  Hospital laboratories especially in Canada have a locked-in community of users and a locked-in budget. Attracting out-patient activity is not within their mandate, and in some provinces is contrary to budget realities.  Changes occur but within a very limited dynamic having more to do with staying connected with the current commercial technical wave.  
There are exceptions, for example Dick Zarbo, pathologist at Henry Ford Health in Michigan has made tremendous transformation in the delivery of pathology services.  Dick spoke at our last Quality Conference.  In October we will be having a presentation by Judy Isaac Renton, on how public health laboratories under pressure of growing necessity redesign the massive flow of information that gets generated with public health crises like influenza outbreaks.    Increasing public demand and pressure for public health information creates new and novel solutions.  NOTE: You can hear more about this presentation at our Quality Conference in Vancouver in October 16-18, 2013 [see: ]

In CMPT meeting customer needs is critical because laboratories don’t have to use our program; in Canada they have choice.  Meeting customer needs has kept our program viable and going for now 30 years.  But that is not enough because over the last decade governments and health authorities have shrunk the number of laboratories through consolidation making our group smaller and impacting on revenues.  In order to continue we have had to be innovative, shrink expenses, grow products and services, and importantly grow our laboratory base.  We have been hugely successful and developing new and better products and services.  We have to develop relationships with the new customers that we want to attract.

That is especially true for our course and our conference.  Course participants generally only take the course once. Even if they were the most satisfied group of course participants in the world, there would be very few that would take the course year over year.  We need the participants to be an ambassador group that will spread the word and encourage their friends and colleagues to see the value in taking the course.  And we need to develop new and better strategies for creating interest.  It is all part of academic innovation.  New participants, new approaches, new activities;  all to attract the customers that we want, but do not have yet.

The focus of laboratory Quality is changing and those at the forefront need to be aware and be prepared to lead.

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