Sunday, April 27, 2014

Making Quality Progress 2014.

Sometimes it is worthwhile to look back at what you have been toiling with to see if you are staying on or near the path that you envisioned, or if the forces of either stagnation or innovation have taken you off into another place.  This is a good time for me to make that look back.

A long time ago, I had the opportunity to get involved in the world of Quality for medical laboratories.  To be truthful, it was not my idea, but rather that of my mentor, John Angus Smith, but I take credit for recognizing an opportunity when it came along and taking to places that John, I don’t think envisioned.  

The primary model was to create a local proficiency testing program for local laboratories because of total frustration with the choices, especially those from out-of-country that were available at the time.  By housing the program inside the university it gave him access available space and to physicians in specialty training (residents) who could help with writing the educational critiques.

When I took over the program, identified as Clinical Microbiology Proficiency Testing (CMPT) as it still is, I quickly realized that being “inside the walls” of the university provided more than space and slaves, but also create an environment for research and development and education in a topic that was essentially beyond the scope and vision of most academics. 

Over time the theme of university based proficiency testing expanded from solely providing local community service in medical laboratory quality assessment to national coverage and then to international.  The technical focus certainly expanded through aggressive research and development into innovative approaches to simulated samples in both clinical and water samples.  Perhaps more importantly, and consistent with our education foundation was the generation of better educational critiques and photographs and treatises and manuscripts, the impact of which has been greatly expanded through electronic access.  

The next phase of theme development was the topic of my last entry [see: ] where it became relevant to share our knowledge, not though manuscript but through hands-on real-time training, with the people and countries that would benefit by establishing their own independent programs that could network with us, or not, depending on their own needs and requirements.  Several have seen value, and have returned for more time with us, others have chosen to work though co-venture studies.  

The next step was probably our most adventurous, when we developed our sister program the UBC Program Office for Laboratory Quality Management (POLQM) because it expanded our them from strictly laboratory technical to laboratory management, and opened up a whole new set of opportunities including study of basic knowledge of laboratory quality management, provision of community services in quality management and education, and participation in the national and beyond dialogue in the themes critical to patient safety through better laboratories.  

One does not have to look very far to see how much information most laboratorians don’t have in the domain of quality to understand how much enthusiasm there has been in with POLQM participants and at the same time how much push back there has been from some laboratorian luddites.  But in the meantime we have still been able to develop a form of graduate program (PhD) and a visiting scientist program. 

Over the past two months we have had the opportunity to work with a visiting scientist from China, a senior laboratory director, with an interest and passion in learning more about laboratory quality and laboratory safety.  It has been a real pleasure and a huge success in having him here.  During his short visit, we have participated in a national Quality Seminar, participated in a number of Laboratory Safety Audits, Created an international (three continent) on-line survey on the Quality aspects of blood culturing, and developed a manuscript soon ready for submission on barriers to success in laboratory improvements.

So as I stand back today and remember where we started and how we have progressed, I feel pretty pleased with where we are.  Where we could have been complacent we have been activist; where we could have been staid we have been innovative.  And where we have met roadblocks we have created go-arounds.  I think my mentor would have been pleased.

PS: Anyone interested in hearing more about the visiting scientist program is welcome to contact.

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