Celebrating World Accreditation Day – 2022 (Plus…..!)

 

Celebrating World Accreditation Day – 2022 (Plus…..!)

When I first started this blog in June 2012, one of the topics that we said that we would discuss was Quality Partners.  I made a rookie mistake by using the phrase but didn’t define it.  We had been using the term in our Certificate Course as far back as 2008, but that was a closed system that few readers would have an opportunity to read.

What we described in the course and later here was that Quality Partners were organizations that worked with and around medical laboratories with the sole intent of helping laboratories develop and maintain their Quality Management Systems with the goals being error reduction and quality improvement. 

As best as I can tell we were the first and only to use this phrase in this context, and maybe still am.  The point is that the laboratory is surrounded by organizations intent of keeping Quality front of mind.  We include in this list:

• Standards Development Bodies
• Accreditation Bodies
• Proficiency Testing Bodies
• Educators
• Professional Organizations
• Equipment and Reagent Suppliers.

 

I return to this concept because every year at this time the International Laboratory Accreditation Cooperation (ILAC) recognizes and celebrates the importance of Accreditation in the process to improve laboratories and protect the public.

Having spent most of my career being involved in Quality Partnership (Standards Development, Accreditation, Proficiency Testing, Educator) I am aware that most laboratorians, even today, still think of Quality Partners more as adversaries.  They tend to see us and generally appreciate us as grudgingly helpful but more often as picky and intrusive.  The over-riding thought is “we don’t make mistakes”. 

And for the most part, they are right… most laboratories do a good job most of the time.  Until they don’t. 

What we have seen over the last few years has been all sorts of false positive and false negative COVID-19 testing errors.  (see:  https://cmpt.ca/covid-19-proficiency-testing-one-year-later/)  We see concerning errors in Proficiency Testing in Gram Staining and in Pre-examination knowledge (see: https://cmpt.ca/publications-newsletter/annual-report/).   The problem is that  wrong information goes out and can impact on patients and their healthcare workers when faulty decisions are made.

Without going into details, last year we saw an organization with little experience in proficiency sample put staff at considerable risk and harm from inappropriate use of the samples.  Had they thought to contact us rather than go directly to harm, we may have reduced anguish and concern.  We are there to prevent bad things from happening.

So from my perspective, I congratulate ALL our Quality Partner colleagues with particular reference to our Accreditation colleagues for remaining committed and helping laboratorians help themselves and protect the public. 

And ILAC, many thanks for shining the light.

But here is a thought.  Maybe the time has come to acknowledge not only the standards development organizations, and the laboratory accreditation organizations, but to formally recognize ALL the laboratory Quality Partners for their contributions for making healthcare safer.

 

Happy World Accreditation Day 2018

We all have our special days.  

For many (most?) we celebrate cultural/social/religious events like Christmas, or Ramadan, or Rosh Hashana, or Mother's Day.  For others there are national birthdays, and for others they are just a good excuse to have a good time (April 20th) or better still, a long week-end if possible at least one a month.   

But there are others, let's call them occupation-recognition days that usually come up as a moment to remind ourselves (and others) that what we do is important.  I’m thinking about National Secretaries’ day, or International Nurses’ Day, or Doctors’ Day, or International Accountants Day, and even National Be Kind to your Lawyers’ Day.

So we should not be too surprised that there is a some days for Qualitists and Qualitologists to celebrate Quality.   Actually we have three days including (a) International Standards Day (October 14^th) which celebrates the day that ISO was founded (which happens to also be Deming’s Birthday), and World Quality Day (the second Thursday in November) which was pronounced by the Chartered Quality Institute (CQI) in (I think) 2008.  

 The third is World Accreditation Day which was founded jointly by the International Accreditation Forum (IAF) and the International Laboratory Accreditation Cooperation (ILAC) to fall on each June 9^th starting also in 2008.  

I am not sure why there are three different days to celebrate Quality especially when Quality, Standards, and Accreditation are so intimately linked, but what-the-hey, each can become its own reason and recognition for partying and celebration and a congratulatory pat on the back.

In our certificate course we talk about Quality Partners as those bodies that exist to help medical laboratories enhance their own quality, and we include Standards Development Bodies and Accreditation Bodies as two of the essential partner groups.  So it is relevant and appropriate that I remind our participants of their special days.

The others are PT/EQA, educators, suppliers, and professional bodies, which reminds me that we should tack on to our celebration calendar October 5 (World Teachers’ Day) and May 15 (Suppliers’ Day).

So for those who plan to celebrate World Accreditation Day today (I see that Standards Council of Canada is have a big “do” today) this is a time for congratulations.  I’ll wait a few days before I re-raise the persistent and annoying disconnect the exists between Accreditation and Quality Improvement.  

And since it I can’t seem to find any reference anywhere for a Work Proficiency Testing / External Quality Assurance Day (World PT/EQA Day) I think I will make its creation and recognition as my new mission.

World Quality Month: right boat but a questionable oar.

I was interested to read in Paul Borawski’s blog about accelerating Quality through recognition of a World Quality Month [see: http://asq.org/blog/2012/11/world-quality-month-accelerating-quality/?goback=.gde_3618260_member_183302883 ] about a rule of thumb that suggests that 70 percent of revenue within healthcare is consumed as Cost of Poor Quality.  Said the other way, only 30 percent of money spent on healthcare is spent constructively.  

Well, as Dana Carvey’s Church Lady would say: “isn’t that special!” .  Count me in the suspicious column.

The Institute of Medicine reports point to a lot of problems in health care, and I would be one to agree.  Complications with respect to medication and hospitalization are disturbing common, and some of the perhaps certainly less than 1percent or less result in serious consequence including new or prolonged illness, or even death.  But the vast majority are either on minimal or negligiable consequence.  This is not meant in any way to trivialize the concept that people should not be made unwell by those committed to the very concept, but not of that adds up to anything close to 70 percent.  

We do have problems in healthcare and one of them is it that as it is a huge collective, broadly beyond broadly diverse based on professional, physical, geographic, social, and financial factors.  Trying to develop generalizable information would at best be near impossible, and probably a lot closer to totally impossible.

In my own little area of medical laboratory quality, I have been able to examine the impacts on CPQ in relatively sophisticated laboratories, by which I mean laboratories that can monitor costs and errors.  After looking at about 1000 reported errors in one facility, I was able to calculate that depending at what point of the testing cycle an error was detected an error took from 30 to greater than 1000 minutes to correct.  The average time, when all errors were combined was about 130 minutes per error.  If applied to a small laboratory this could result in as much as 30 percent of human resource time being spend on working on the consequences of previous error,  In a very large laboratory it would be much closer to 11 percent.  Both of these are a terrible waste of time and energy and money, but both are also a lot lower than 70 percent.  

While I am interested in Paul's comment, I am a little suspicious about the accuracy and precision.

But since I am on a roll, let me raise another thought (the word “concern” would be too harsh and to excessive).  For many years the world has celebrated Quality in relative silence.  World Standards Day, which has existed since 1970 has been in relative obscurity until perhaps the last 5 or 6 years.  World Standards Cooperation has been around since 2001, but has become more widely known since it has created is academic day focus.

As much as I like to party and celebrate, I wonder if the creation of a World Quality Month will enhance or compete with these other activities, and I wonder if the Quality community will achieve better of more positive recognition based on this additional month, or just more confusion.  

Now I also understand that Quality is a lot broader than Standards, but there is an important connection between Quality and W. Edwards Deming and World Standards Day, since October 14^th is also Deming’s birthday.   

How will we respond when another groups within the Quality arena decide to declare World Accreditation Day, or World Proficiency Testing month, or perhaps the decade for World Quality Educator Programs.   And maybe some will consider it important to create awareness through World Lean Day or World Six Sigma Day, or we will all want to celebrate Walter Shewhart on World Quality Control Week.   And maybe the Committee on Consumer Policy (COPOLC) will move forward on World Customer Appreciation Day.   

Actually I think that some of these are actually interesting ideas.

To be clear, I think that communication is always important to raise awareness, and raised awareness through greater communication results in more and better (?) activity.  And bringing awareness through multiple events can be very enhancing, provided that they don’t end up in competition and as a distraction.

But that is just my opinion.

PS: Paul, maybe you want to re-think that 70 percent number.  And if it is true, I won’t be trilled, but it is better to know than to be oblivious.