5 Principles for Lab Quality
When it comes to quality improvement (QI), it is the master, W. Edwards Deming, who told us of 14 principles that guide QI efforts worldwide.
While Deming’s approach, almost 70 years ago, is credited for the success of post WWII Japanese industrial growth and for transforming the American automobile industry, his principles are easily adapted to health care and even more valuable today as our payment system shifts to a value-based model.
Of those 14 principles, five come to mind for laboratory quality:
When it comes to quality improvement it’s more important to empower employees through your leadership and hire the right people versus policing them.
Encourage a culture where teams are comfortable reporting errors and feel a sense of pride when contributing to the QI process.
Make sure to create alliances with other departments such as IT to facilitate collaboration and information flow.
Contributing Lab Leaders
Patty Eschliman, MHA, MLS(ASCP)CM, DLMCM
Immediate-Past President and Executive Committee Member
Clinical Laboratory Management Association
BOC Board Governor
American Society of Clinical Pathologists
Madonna Rehabilitation Hospital,
Manage the process, not the people
Laboratory professionals inherently strive for excellence. By concentrating on consistent processes and setting clear expectations, variation decreases and quality increases. This requires leadership principles that empower individuals and place managers in charge of improving processes, not policing workers. This is why your leadership education is so important, and why hiring or training a laboratory professional that specializes in quality management can be so impactful to your organization.
Drive out fear
Create a Just Culture so that everyone is unafraid to report errors and encouraged to suggest innovation. Without fear of reprimand, team members will learn to report all variances, which will enhance the data pool for greater learning. See how fast this culture grows when a punitive model for errors is replaced with one of reward for reporting errors and where laboratory improvements are celebrated. Lead by example! Showing your vulnerability to make mistakes makes you a more authentic leader. We are all in this together, and a strong leader educates, inspires and empowers others.
If you cannot measure it, you cannot improve it
Meaningful QI is data-driven. Data is non-emotional. It is what it is. Stephen R. Covey, in his book The 7 Habits of Highly Effective People, said, “Start with the end in mind. Find out what it is you want to improve and then start collecting the data. The data will turn your suspicions into fact and provide you with areas of opportunity.” This is your calling to get outside of the lab and collaborate with other departments. Break down institutional silos to see how other departments handle data and discover how working together accelerates positive patient outcomes. Make a friend in the IT department who can ﬁnd ways to collect data that you would have never thought possible.
Abandon the quality assurance approach
Creating quality initiatives around laboratory inspections and artiﬁcial targets or remaining reactive to variances in quality will not fully embrace long-lasting and measurable success. While Clinical Laboratory Improvement Amendments of 1988 (CLIA) regulations ensure that labs are meeting minimal quality requirements, it is no longer sufﬁcient when considering the signiﬁcant contribution the lab has to patient outcomes and value-based reimbursement. This is an opportunity to empower your team to look beyond the laboratory inspection checklist and think outside of the box. Develop a quality manual that provides guidance and sets expectations.
Eliminate barriers that prevent workers from feeling pride in what they do
A successful QI program empowers everyone to do their best. Because we inherently strive for excellence and are often competitive by nature, laboratory professionals are hard-wired to fix problems. Creating a loop that continually evaluates the process allows everyone to be involved in the laboratory’s success, which increases engagement and improves company loyalty. Win points with your administrative team by reducing employee turnover while reducing costs by improving quality.
Where can you go to get more information on laboratory quality and identify the tools you need to succeed in your quest for a successful QI program? Search no further than the Quality Insights for Quality Outcomes series brought to you by LabLeaders and CLMA. Thought leaders from CLMA met with LabLeaders for a discussion on quality management. Check out the video for a behind the scenes look at this collaboration and review additional content from the series here.
Quality Improvement: The Process to Improve Patient Safety
By Karen Golemboski
The Chair of the American Society for Clinical Laboratory Science (ASCLS) Patient Safety Committee shares a simple-but-powerful QI methodology and explains how to test one intervention at a time with the goal of proving patient care.
How to Choose a Quality Improvement Project
By Michael Astion, MD, PhD
This articles shares ten helpful strategies for choosing a Quality Improvement project that will have a high-impact and boost ROI.
How Does a Laboratory Measure Process Improvement?
By Michael A. Noble, MD, FRCP(C) and Paul Valenstein, MD
This article shares how to use the Clinical and Laboratory Standards Institute’s approved guidelines to select the best quality indicators to measure.