Monday, September 9, 2013

The Quality Carry-over

The Quality Carry-over

Others have written on this topic, and I have alluded to it previously as well.  Quality is an interesting arena in which one can work because once you have bought into the philosophy it tends to spill over into other work and non-work areas of your life.
You might say that other professions do this as well.  Physicians and nurses often find hobbies related to health information, such as becoming health historians or health artists, or becoming health information apps developers.  Chefs often become sophisticated foodies, searching out the perfect tomato or traveling to the out most regions to savour the perfect dumpling.  Metal workers become sculptors.  Profession becomes hobby.

But Quality is different.  True, Qualitologists often find themselves creating their own personal OFI lists, and finding ways to maintain personal records and receipts in a way that would paralyze a “normal person”.  Quality Carry-over goes beyond that because the qualitologist starts seeing the “flaws” in the world around them and then starts to try to do something about them.  This is not profession becoming hobby; it is profession become obsession. 

An example.  Over the last while I have had some health issues that have required me to stop being a physician and start becoming a patient.    And that is rarely a good thing because as a general rule we are not very compliant patients.  We suffer from “I know better”.

But there are some areas in which we do know better.  Over a short hospitalization I was seen by 3 medical specialists and probably 8 nurses and 5 technologists.  All of them had tests to record and reports to write, so that you would imagine that there would be a lot of information generated.  But when I visited the out patient clinic, none of the records or reports (NONE) was available.  In addition, none of the information was conveyed to my family doctor (NONE !) even though I was informed that he would be responsible for my follow-up.  My prescription was written by one physician who informed me that I should go to my family physician for refills which I would take for an extended period, but no one told him was I was supposed to be taking.  And finally while in the clinic I found that there is another fellow with my same first name but with different last name, different age, different birthday, and they still managed to get the two of us and our records mixed up.  Worst off, his wife and my wife happen to be good friends, so the issues started to become a breach of personal confidentiality.

I suspect that many people would be miffed, and some would probably get angry.  In some countries, not Canada, we might even be getting close to the law-suit level of discontent.  But I didn't go there.  Instead, I wrote a memo to the person that I perceived as the one most likely to “get it”.  I understand that this is the system in which she normally works and probably sees  as problematic but normal and don’t see any way around it. 

I mentioned that as a healthcare savvy person I was going to be able to manoeuvre through this mess, even if it meant writing my own prescriptions and refills.  But for many of their patients this would be chaos, and the risk of a bad event would be substantial.  I suspect they happen all the time, but they just get lost and missed in the shuffle.

I mentioned to her about occurrence awareness and management, and how to organize an Opportunities for Improvement (OFI) list, and offered my assistance in helping their group develop a strategy and goals for quality improvement.

To date there is no answer.  I will wait a while and re-contact her.  If that doesn't work, I can always kick it upstairs until I get a response.

1 comment:

  1. "To date there is no answer." I can imagine. The first and foremost would be to instill in EVERY employee a sense of urgency for continuous improvement as some companies in Japan have found a way to do despite the hierarchical nature of their culture. In the "West" most people just think it's not their mission and anyways "it was always so". QM people are of a different breed but tend to get isolated pretty fast in big organizations. As the ISO standards say: quality is a function of top management. But no, it isn't unless your name is Jack Welch.


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