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Clinical Microbiology
Proficiency Testing (CMPT), the PT program that I chair, has just successfully
undergone our 10th annual assessment visit by our certification body
(SAI Global). We are the only
Proficiency Testing program in Canada or the United States serving medical
laboratories with a continuous 10 year track record of successful external
evaluation.
Congratulations to us.
Voluntary oversight is an
interesting activity in which to be engaged.
In Canada, at least for the time being, proficiency testing bodies providing
services and challenges for medical laboratories are not required to be
externally audited by any agency in any jurisdiction. We can be accredited to ISO 17043:2010 if we
want, or we can be certified to ISO9001:2008, or we can do nothing. It is our choice. If some authorities know what we choose,
nobody officially seems to care. To the
best of my knowledge, we have one organization that is voluntarily accredited
to ISO 17043, and there is one organization certified to ISO 9001 (that is us). The remaining programs, large and small have
to date decided that oversight provides them no particular benefit.
I suspect that the
laboratories to which we provide service see the world a little differently. When we surveyed our laboratories, they
reported that most see our certification as providing evidence of our Quality
and provided a basis for trusting our Quality and Competence. That being said, there is no evidence that
laboratories make any decisions in which PT program they will participate,
based on Quality oversight. Further,
there is little doubt that if the cost of our program was perceived as too high, or if some of our
“competitors” decided to become more aggressive, many of our laboratories would
drop our program. Loyalty goes only so
far.
More to the point, I suspect
it would be exceedingly difficult, to develop any evidence that would suggest
or support that laboratories that participate with over-sighted PT programs make
fewer errors or provide a higher level of patient safety.
I will take this one step
further. I am aware of only one medical
laboratory accreditation body in Canada that has sought external assessment,
and I can see no evidence that would suggest that laboratories accredited to
that program are safer or better than those accredited by non-oversighted
accreditation bodies. [That being said,
we do have some anecdotal evidence that laboratories with NO accreditation may
be inferior].
So there is a reality that
if we think we are following our Quality journey for some tangible benefit to
patient safety or medical laboratory improvement, we probably would be
wrong. The benefits of Quality lie almost
exclusively for us, with some intangibles that go outside the house.
First off, by working
through a structured quality process we catch our mistakes earlier, and prevent
most from repeating. By learning from
our mistakes and keeping our errors in–house, we save substantial amounts of
time, and energy and money. I estimate
this saves our bottom line probably 5-7 percent.
Second, we are a real-life
example of the phrase “Quality improves Culture and Culture improves Quality”. CMPT has a very powerful Culture of
Quality. After 10 years, our Quality
system is at the core of everything we do.
It is the basis of our innovation efforts, our internal communication,
our discipline of continual improvement, and our dedication to providing the
best service that we can for the laboratories that work with us.
When we plot our culture map
we are very high on Market (customer awareness) and Adhocracy (innovation) and
Clan (intergroup dynamics) and a lower on Hierarchy (internal leadership and
requirements). We are exactly where we
want to be.
There are some lesser tangibles that result from our Quality strategy. We get
a lot of recognition from other countries and are perceived by many as a leader
in method development and innovation for proficiency testing.
Considering that we are really a small group, that recognition is a real
plus and driver for us.
And perhaps very
importantly, had CMPT not embraced Quality, then we would never have reached
the point of opening our sister program, the Program Office for Laboratory
Quality Management, and would not have experienced all the huge pluses that
have accrued from that.
With all that said, we are
absolutely certain that going down the Quality path when we did has given us a
level of success that is off-the-scales.
A truly brilliant decision
of which I have absolutely no doubt.
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