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.

Quality and the Tower of Babel

For those of us in the Northern Hemisphere, September tends to be the end of summer and the return to more active work.  Welcome back.

According to the Bible (Book of Genesis) after the Great Flood all the people spoke a single language.  They migrated to the land of Shinar (modern Iraq?) and decided to build a city with a great tower.  God had distrust of this large group and their motives.  He confused their communication by creating the many different languages.  The work on the tower ceased and people scattered across the face of the earth.

Over the last while I have been communicating with a wide variety of groups that seem to have a common purpose to make health and patient care better.  But somewhere along the way they have become very fragmented and increasingly disconnected. 

Some of them fall into that collective group of quality partners.  This is the group of standards development organizations, accreditation bodies, proficiency testing providers, educator groups, professional organizations, and equipment and reagent suppliers.  Add to that the public representatives through the legislators, regulators, litigators, and the media.  More recently I have increasingly had activities with the groups, mainly in the clinical Patient Safety arena, and a new group (new to me) focused on Medical Diagnostic Errors.  

Some of these groups have splintered off even more distinctly, focused on Quality in resource limited regions while others are more interested in the opportunities in the wealthier countries, and others still fall somewhere in between because their interests are in the resource limited regions that are found within the wealthy countries. 

Like the aforementioned Babel, each group seems to be developing its own sets of definitions and jargon and discussion groups.  Each has its own set of meetings, which not surprisingly all occur at or around the same time of the year, but sufficiently distant that it would be difficult to combine.  
In Canada I recently discovered that three groups all with common interest have meetings planned for June 2012, two of them in the same hotel but a week apart and the third separated off by about a two hour drive and an additional week.  What was interesting to me was that none of the groups was aware that the others were meeting or even planning common discussions.  And Canada, while big in geography, doesn’t have all that many people.  How “Shinar-like” is that.  (Am I adding to the confusion by creating even more new words?). 

The problem (at least in my mind) is that as we all spin out further and more disparately, the opportunities for common goals get muddied and muddled.  Rather that building a large tower to the heavens we end up with a bunch of low-rises or maybe townhouses. Not that low-rises and townhouses are bad things, but I suspect that was not our collective primary purpose.  

As it turns out, all these groups appear to have a single vehicle that potentially can draw them together.  LinkedIn, the original social media has forums for all these groups.  If you have the time and inclination, a person can connect to all these interested parties and find the common links. 

To explore this further go to www.linkedin.com and hit the Group Directory.

While you are at it, for those interested in our on-line course in Laboratory Quality Management, go to www.polqm.ca.  Our registration for January 11, 2012 as begun.