Showing posts with label
Canadian Standards Assocation.
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Showing posts with label
Canadian Standards Assocation.
Show all posts
I am putting together a presentation for a meeting in Quebec City in June. I was invited to talk about the impact of Canadian Standards Association (CSA) documents on Canadian healthcare. As I am putting it together I recall a conversation that I had at another meeting about 10 years where a Canadian microbiologist spoke up asking why I would put in any time with the CSA because they did so little for healthcare other than to check that the electrical plugs on radios and equipment were OK. I suspect that at that time vast majority of my colleagues probably thought this same way. We will see if things have changed.
To be fair to my colleagues, most of their time is spend being hands-on technical laboratorians and most of the documents that they look are written by the Clinical and Laboratory Standards Institute. The CLSI is a developer of many documents of critical interest for the laboratory worker. Many of their documents are used world wide. CLSI documents fill a specific niche extremely well. But if you think about spheres of influence as a form of Venn diagram, the areas where CLSI and CSA cross over is quite narrow, and there are many health related documents that are addressed by CSA that are not addressed by other organizations, including CLSI.
I have spent a lot of career time working around the CSA. I helped develop and chair the technical committee to focus on medical laboratory Quality Systems, and with CSA support lead the Canadian delegation to the ISO. Through that committee we participated in writing key documents for laboratory Quality (ISO 15189), laboratory safety (ISO 15190), and point-of-care (ISO 22870) all of which became national documents. We have shared in developing documents on medical laboratory Risk Management, antimicrobial testing, and packaging labelling. So from that point of view alone I could justify the time spent working with CSA was time well spent.
But it was when I moved up a step to being a part of the Strategic Steering Committee for Heath Care Technologies and Services that I truly appreciated how much CSA is a health standards body. Today there are hundreds of healthcare related CSA documents that impact medical devices, facilities engineering, anaesthetic gases, peri-operative procedures, renal dialysis, blood transfusion, tissue transplantation, equipment cleaning and sterilization and infection control, radiology, ultra sound, dentistry, caring for disabilities and medication packaging. There are essential standards that impact every aspect of the medical laboratory. Indeed it is hard to think of any part of healthcare inside or outside of health care facilities that is not directly influenced by CSA standards.
I wonder why after 50 years of engagement in healthcare, there continues to be this huge disconnect between impact and awareness.
My guess is that there are a variety of reasons that come down to a few root causes. First is that CSA works in the arena of documents creation, and to many in healthcare this is just plain BORING. Additionally there are so many organizations that truly believe that document development is a “nickel-dime” process and that they can do it themselves. And they can and do. It is just that they do it very badly. I sat on the standards and guidelines committee for a medical organization for a number of years. The number of trash documents was tragic. Recent experiences tell me that little has changed. The consequence is that there is little regard or even awareness in document source or relevancy. Just photocopy it and be done with it.
A contributing factor is that Quality issues have almost no play in any aspect of medical education at any level; it is for all intents absent from undergraduate and post graduate education. The words like “standards development organizations” or “quality partners” or “accreditation” or “proficiency” never come up; ever. Quality means newer or fancier, not better. Certainly no one would ever discuss an essential quality partner like the CSA. Healthcare professionals have little idea about what is a document and what is a standard until well into their career. It is a stumbling-bumbling process. Perhaps the fact that there is a meeting for laboratorians and I have been invited to present on the topic is a key step forward.
But in the meantime, for us that are interested, the field remains wide open, filled with opportunity and promise. And a real sense of accomplishment, knowing that we contribute to greater healthcare and society in truly essential ways that others can not understand.
For those interested, I will post the presentation file after the meeting.
Also, you can visit the CSA on-line store catalogue at: www.shop.csa.ca Click on the Publications link at the top.
The other day I received a letter from the Canadian Standards Association that I am being recognized with a 2011 Award of Merit in recognition for “visionary leadership, renowned expertise and dedication to the development and advancement of medical laboratory standards”. I will receive the award in June at the CSA Annual Meeting in Victoria BC.
I am not prone to personal aggrandizement, but I must say that I am really pleased by this award. In my world, receiving a CSA Award of Merit is equivalent to receiving an Oscar or Genie. (For those not from Canada, a Genie is a Canadian Cinema Award statue). In the world of standards development, Canada and the Canadian Standards Association is a world leader within a very small group of leaders; ISO (obviously), CSA (Canada), DIN (Germany), BSI (UK) and maybe NATA (Australia). So to be a recipient of a CSA award is a big deal.
Similar to other organizations the Canadian Standards Association was developed to solve the problem of incompatible technical resources that manifested during WW1. By 1918 the organization was recognized by the young Canadian federal government as the Canadian Engineering Standards Association (CESA) with documents on the railway, bridges, and electricity, all the essential issues of the developing era of the 1920’s. The Canadian Electrical Code was the milestone document in 1927.
Over the years, CSA (so named in the early 1950’s) has been on the leading edge of every modern development, timber, steel, nuclear power, public health and occupational health, and now environmental health.
It would be impossible to estimate how many children would have been crippled or worse had it not been for CSA focus on sports (hockey, bicycles) helmets. But it likely is in the millions.
Many qualitologists (including me) are aware that one of the two seed documents that lead to ISO9000 was developed by the US military and later modified for civilian use by BSI. Far fewer (again, including me) know that the other document was from CSA’s Z299 series for quality assurance for the nuclear industry.
As Canadians we all know about the CSA mark on our toasters, and radios, and helmets, but I suspect most are unaware of the major mark on international health that CSA has played in the design of health care facilities, delivery of anaesthesia and dental care, and diabetic care, sterilization and blood transfusion and transplantation. Hospitals around the world have benefited from CSA published standards of care.
My personal connection with CSA began in 1996 when it rescued our fledgling Canadian Advisory Committee that was engaged with the formulation of ISO15189. We had been raising our own resources, traveling at our own expence, and depending upon the good graces of our employers. Had CSA not come along, we would not have been able to stay engaged in the development of that standard. I don’t know what the document would have looked like in our absence, but I can say with absolute confidence, that it would not have been as good as it is now.
More importantly the quality revolution that has now taken hold in medical laboratories now sweeping across Canada never would have developed the traction to get the conversation started.
So I am really pleased to have had a long standing link with CSA, and am grateful beyond grateful for the recognition. It means a lot to me.
I have a lot of time for the Canadian Standards Association.
And so should you.
I have mentioned the Montreal Conference a few times. Since it occurs on Wednesday this week, writing about it today is not to encourage more folks to attend. That ship has gone. We anticipate an audience which will be about 70 percent of what we had hoped for, but well over our break-even point. Since the point of this conference was not about generating revenue, I am satisfied with what we have.
Our objective was to get the message out about improving Quality communication in Canada. Between the people who come, and the coverage that we will generate between 3 web-log (blog) sites and offerings of the powerpoint files, and the academic presentations that get generated, we will get our messsage out.
I will provide a conference summary article and make the powerpoint presentations available for sharing after Wednesday April 5 at www.POLQM.ca. While ISO9001 and ISO15189 speak to communication, I perceive these requirements under the classification of “necessary, but not sufficient”. In the Canadian Standards Association’s book 15189 Essentials: an implementation guide we speak in more detail about how to implement a quality communication program (you can order the book through www.csa.ca through the on-line bookstore.
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Developing an effective quality communication program in the medical laboratory has to look at developing both an in-house information program plus bringing in materials from outside. Laboratorians have a lot of choice; we can make this as expensive or as cheap as we want, and realize that the depth of the quality communication system does not necessarily have a linear relationship with cost. Expensive is not necessarily better.
What is an interesting consideration is that as an early adopter, laboratories develop a third arm and major opportunity. Gaining experience leads to sharing the message, and sharing the message creates opportunity for revenue generation, which can be put back into the quality program to reduce it as a cost centre, and moves towards being revenue neutral, or even better. Even in a socialist single-payer health care system, generating revenues to promote quality for bringing in speakers or for sending people away is a good thing. We cover this in a variety of ways at the conference.
What the quality program needs is time. In my presentation I suggest components that would add up to 30-40 hours a month, which pretty much reinforces the imperative of creating Quality Manager and Quality Team positions. To make it clear, I don’t expect every laboratory around the world to put in a communication program that consumes 25 percent or more of a person’s full time, but in every laboratory sharing information with staff on some regular schedule improves knowledge and engagement. Even in laboratories in developing countries, this improves the focus of care and reduces poor care.
I know and understand this leads to the obvious question of whether improved communication results in improved quality and secondly, will improved quality result in reduced cost and improved laboratory services. Fortunately there is a lot of published material that supports positive responses to both.
If you are planning to go to the meeting at Le Westin Hotel in Montreal, come on over and let me know that you are a MMLQR reader. If we have a moment to chat, the coffee is on me.
