Showing posts with label checklists. Show all posts
Showing posts with label checklists. Show all posts

Thursday, December 23, 2010

Message to self

Let me start by saying that I do a lot of surveys. To date my account has 82 surveys completed and an additional 3 currently active.  I survey students regularly during courses, and annually we do at least one customer satisfaction survey for CMPT.  I have done surveys for the International Organization for Standardization (ISO) and for International Laboratory Accreditation Cooperation (ILAC).  Over the years I have become adept at creating surveys that address the issues that I want addressed.

Last week's survey was my first experiment of linking a survey to a discussion website like MMLQR.  I would not call it a totally successful experiment. 

When I look at the reported results, first I noted that we are attracting a variety of laboratory Quality professionals from Canada and internationally.  There are some positive trends.  Based on a 6-point Likert scale, this site was ranked either as Excellent or Good by near everyone with regard to variety of topics, relevance, clarity, accessibility, and refreshment.  There were no "poor" or "unacceptable" responses.  The same was true for the Overall assessment.

So this is all good, Yes?
Well it provides documentation that supports impressions based on the progressively increasing readership, and it confirms that the people that I am interested in engaging in conversation aer finding the site.  But based upon the number of tracked page views, it looks like less than 4 percent of people connecting to MMLQR have responded to the survey.

With the information that I can garner, I don't know how many people opened the survey but chose to anwer no questions, but I assume that that is a very small number

So there is a problem, but a generalisable problem.  Almost all the surveys I have done in the past have been to a closed or faily closed population, where I could go back to the group and try again and again.  This is a survey to an open population.  In that regard it is similar to attempting to do a satisfaction survey of people exiting a laboratory patient service centre, or of physicians that use laboratory services.  
In all these situations, one can generate a denominator of how many potential responses there could have been.  The challenge is how does one increase the numerator without generating bias, both positive and negative.

In the laboratory setting, one might try creating focus groups as definable groups, but one has to create incentives to garner participation.  This is potentially expensive and would only be applicable if one risked confidentiality breaches.  One could combine focus groups with electronic surveying, but still one would have to have identifiers to work with.
In this setting, I have no access to identifiers, and no obvious inducements that might entice a response.

So it is back to the drawing board with some questions to be asked, like who do I want to attract to the survey, and how can I entice them to participate, and what is a sufficient cluster, and what kinds of questions will capture the information that I want.  And maybe to affirm why I want to generate the information.

It's kind of like my own PDSA

If I come up with some answers I will try again.
In the meantime if you are in the 4%, many thanks for participating.

In the meantime, I am going to take a few days off and come up with my predictions and resolutions for a happy and Quality 2011.

For those of you who celebrate the day, Merry Christmas.

m

Saturday, October 9, 2010

Some easy and cheap things that you can do that will improve laboratory quality (Part 2)

I previously mentioned the Juran Quality Cost Model which points out that doing small things to improve prevention and assessment, have a big impact on to Quality spending, because they drive the costs of failure down by reducing the amount of failure.
I think that the model has merit.

The extension of the model is that inexpensive and easy to perform improvements can save TEEM (time, effort, energy and money).  As much as I am truly fatigued of the term, think about the “low hanging fruit” that will improve Quality. In part 1, I mentioned simplifying procedures, and improving procedure communicability, and introducing Quality discussion. 
So, continuing on the discussion: 

Create your own personal Quality Checklist.
There are a bunch of things that you know you should do on a regular basis, but for the most part they usually don’t get done until something official comes along.  Maybe its an upcoming accreditation, maybe it is a post-complaint investigation.  I know that we are all well meaning, but we can be busy or distracted.
So set yourself a check list (aka “to do” list or “personal audit” list).  Don’t wait for someone to make one for you (when it comes from your spouse, it becomes a “honey do” list).
A few things to put on your list:
1:         Have I checked the procedures that I am working on now in the last 3 months for changes?
2:         Have I checked to see if my personal short notes on the procedure are still consistent with the changes that have occurred?
3:         Did I update my own short notes?
4:         Did I check to see if there are short notes attached to my bench or analyzer, and have they been similarly kept current?
5:         Did I have one incident during the last month or three months that would quality as a learning opportunity or opportunity for improvement?  Did I make a personal notation in my own OFI book (more on this later.)
6:         Did I have at least one continuing education activity in the last 3 months, and did I record it.  That might include:
  •         Read a book or article or website or see a video related to my work
  •        Attend a seminar or meeting or interest group related to my work
  •         Participate in a continuing education related course either in person or on-line
Keep the checklist in a private place, but check it at least once every 3 months.  It will take no longer than 2 minutes to check, and should generate no more than 10 minutes of activity.   But in a year you will have 4 checks of 6 points (that’s 24 check points) and in two years you will have 48.  


Do one internal audit a month.
We all know and understand that working in a laboratory is a lot like working in forestry.  Most of your time is spent jumping from one fire to another, and soon all you are doing is stomping out fires.  That is really important work, but some of those fires are self-induced because you never got back to check that the fire was actually put out.  That is what internal audits are for.

I find that so many of us like to think BIG.  That’s good for dreams, ambition, and goals.  For internal audits, thing SMALL.

An internal audit does not have to be much more that taking the personal checklist as above, and make it a little broader.  We need to be checking to make sure we are on track.  It’s just part of the Plan-Do-Check-Act thing, but make it really narrow and make it really specific.  And don’t take anymore than 30 minutes to get it done (45 minutes tops).  For example ...
  1. Check the benches to confirm they are neat and clean at the end of the day?
  2. Check the reagent kits to confirm that some one recorded the “open date” and the “expiry date”.
  3. Check the equipment temperature recording charts to confirm they are being filled in.
  4. Check the Proficiency Testing results to confirm that someone looked at them, and signed them off.
  5. Check the SOPs to confirm that they have been reviewed on time.  (If you set that to happen with a few review times each month, then you don’t have the burden of doing them all year’s end).
  6. Check to see if the preventive maintenance schedule is being followed on time.
Then write the results down and give a copy to someone in laboratory management.  That is all you need for an internal audit report.  You can draw up your own list, but keep it fewer than 12 (if the list gets too big, most will just drop it).  Once again, if you did each of these once every 6 months, at the end of one year you would have 12 completed internal audits and at the end of two years you would have 24.  If your list had 12 and you did them each twice a year, then at the end of a year you would have completed 24 internal audits.  That is huge!

The reality is that most of our colleagues would like to focus on doing better, and doing error free work, but we tend to make Quality tedious and excessive and overwhelming.  Too many rules and too many requirements.  And administration sees it as expensive.  So try this as something different.

More cheap and easy later.
m