The Meaning of Quality
At our Quality Management
Conference for Medical Laboratories last month, one of our speakers made a
throw-away comment, that the word “Quality” is so overused these days that he
was no longer sure what people meant by the term. What intrigued me was that a similar comment was
made by another speaker as well, and indeed the concept became an on-going
recurrent theme throughout the meeting.
I understand where they are
coming from, and I feel a certain empathy, but in all due respect, I think that
the sentiment is wrong. Quality does have meaning.
On the other hand, one of
our speakers reached back into the past and made a relevant comment: “Quality is not a word, it is a journey” [ note: a variant from Ralph Waldo Emerson (?)
dated around 1854 – life is a journey not a destination. The Quality variant has been used since the
early 1990s] , As much as this
sounds like an old truism, I think it is still valid and still an appropriate
attitude and approach towards understanding the discipline in which we work.
Let me pull a few things
together here.
With regret we still see all
too many laboratories with a track record of repeat accreditation as far back as the early
1970s. If you applied the Crosby
definition of Quality being defined as meeting requirements, then you would
call repeated accreditation meaning Quality.
But you could be wrong.
Many repeat accreditations
were a joke. Laboratories doing nothing
for 4 years and 9 months manifesting no evidence of improvement, and then
spending 3 months to tidy up manuals and fill in QC charts. An accreditation visit, lasting maybe 4 hours
done haphazardly, which is then followed by an approval process, perhaps with
some recommendations for improvement which don’t occur. The laboratory then takes a post
accreditation breather hiatus of about 4 years and 9 months, and then gets
started again. There is no evidence of a
journey here. It is Quality in name
only. That theme gets carried out in so
many ways. Quality Manuals are beautifully
created, only to be locked up in an office more as a trophy on display than as
a useful and usable document. Quality in
word only; no journey here.
We see laboratories where
management hands off the Quality portfolio to the senior staff (or worse the
junior staff) expecting receive a report of quality indicators for signature
once a month, but never actually doing anything with the information; and
calling that Quality.
We see laboratories where
management receives continuing education funds from institutional resources,
but 90 percent or more is spent on management level travel, and 10 percent goes
to technologist training. Again, static
words.
We see laboratories that
bring in consultants to review and propose grandiose plans for leaning and
implementing quality software or purchasing new bells and whistles, but little
happens to justify the expenditure, with little consequence.
We see evidence of static
quality all the time; it is no wonder folks fatigue of hearing the word.
Quality is about progress,
about continual improvement, about setting goals for change and making the
commitment to follow through. Quality is
about giving voice to both compliments and critiques to discover what you are doing
well and more importantly discovering what you can do better.
So I agree there is lots of
evidence that if action without meaning continues to be the norm, then the term
Quality has lost its meaning. So if you
are fatigued by the “journey not a destination” homily, let me offer another more
functional definition.
Quality is the commitment to
continuous positive change.
PS: If you are interested in viewing the
presentations from our conference follow:
http://polqm.ca/conference_2013/conference_2013/conference_home.htm
Go to the LEFT
margin and click on SCHEDULE
Each presentation
is linked to the author’s title.
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