Thursday, November 1, 2018

Customer Service - The Paradigm Shift in Laboratory Quality

Customer Service - The Paradigm Shift in Laboratory Quality
In the 18th Century, Immanuel Kant writing in Critique of Pure Reason (1787) described the change in approach to scientific study as a “revolution of the way of thinking”.  In the 20th century, Thomas Kuhn in his book The Structure of Scientific Revolutions (1962) advanced the phraseology to “paradigm shift”.  By whichever phrase we want to call it, today we are going through an new phase in thought and practice in Laboratory Quality, especially as it refers to customers and service, that is truly a significant shift.

Recently I hosted a conference in Vancouver on the topic of Quality Improvement, Knowing your Customers.  One of our speakers, Colleen Taylor, in a most creative way talked about the dual understanding of the word Patient.  In healthcare we use Patient to refer to one of our customer groups, the person who is the end-user of our products or services.  Equally “patient” describes our all-too-common approach to the end-user: “ You are tired of waiting?  Well we are all very important and very busy, and you just have to be PATIENT.  So just go sit there and we will get to you when we get to you.  Just sit there and be quiet, and you better be darn grateful when we get around to providing you with our time and services.”  

The rest of the world has figured out that that is no longer a winning strategy.  Increasingly customers have figured out there is always choice.  Hospitality, and retail, and banking and schools have figured it out; making an unhappy customer leads to an unhappy customer and a bunch of unhappy friends, and one day you look around and there are fewer and fewer people coming in your door.   And all of a sudden, your business is in trouble.  

Think it can’t happen to medical laboratories?  Point-of-Care Testing did not start in a vacuum.  Pharmacy based testing didn’t just happen.  Theranos, may have turned out to be a failure, but the reality was that Silicon Valley was responding to a perceived need, and there is every reason to believe that the next change will be far 
more successful.  

So at our conference we learned some truly important lessons. 

Hospitality industry can track millions of customer experiences, and can maintain complaints at a level of 3 per 10,000 (sigma 6.17).  They track and correct because they understand that every complaint that goes through the door unresolved gets increasingly expensive.

Tracking customer satisfaction in healthcare facilities can be done competently and comprehensively on a same day basis, and indeed on a same hour basis. 

Healthcare executive administrations are looking for service excellence solutions

International Organization for Standardization (ISO) is developing new standards and tools in service excellence under a new technical committee (ISO TC312 Excellence in Service).  

Some laboratories are developing some novel approaches for improving customer experiences

The approaches of “the customer is always right” and “the customer always comes first” are being replaced by “Your Customer have to come second because your staff have to come first.  Staff who are acknowledged and appreciated for their skills will take care of your customers needs in ways that are in both the short and long term successful”.   

We can shift staff attitudes and culture using thoughtful analysis using techniques like Organizational Culture Assessment Instrument (OCAI) and staff management skills and techniques.  

Small changes can have big impacts. Small changes regularly have huge impact.  

Starting now is ALWAYS better than starting later.

To be clear, other aspects of laboratory quality can not be forgotten about.  Areas like error awareness, error reduction, opportunities for improvement through audit and prevention and correction, continuing education, continual improvement throughout the pre- peri- post- and examination phases will not go away.  But their impact and success will be much enhanced through the dynamic of staff and customer satisfaction. 

For those interested in seeing some of the materials from our conference/workshop you can visit