CEO SUMMARY: With almost 300 speakers, attendees, and vendors in attendance from seven countries, Lab Quality Confab was a significant milestone for the global lab industry. On one level, it was a sign that the quality improvement trend has come of age. On another level, it provided ample and powerful evidence that labs using Lean and Six Sigma are actively raising the benchmarks for measuring the quality of laboratory testing services.
IF ANYONE STILL DOUBTS THAT THE ERA OF QUALITY MANAGEMENT has reached the laboratory profession, 300 speakers, attendees, and vendors at the Lab Quality Confab in Atlanta last month would vociferously argue otherwise.
The list of participants at this first annual event was a Who’s Who of the nation’s most prominent laboratories, including hospital/health system labs, independent laboratories, pathology group practices, and industry vendors. That so many respected laboratory organizations have active and thriving quality management programs is powerful evidence that quality management systems—such as Lean, Six Sigma, and ISO 15189—have achieved mainstream status in this country.
A common theme linked the 50 presentations and sessions, conducted over the four days of September 18-21. This theme is the universal success laboratories experience as they use quality management methods to implement improvements in all aspects of services and operations.
That’s a remarkable statement about the use of quality management methods by clinical laboratories, pathology group practices, and hospitals. When these techniques are applied with a basic level of expertise and effort, the consistent outcome is improvement in the targeted objective. Not every project generates spectacular increases in quality and productivity. However, qual- ity management methods invariably deliver enough gains to motivate the laboratory or hospital to continue their use.
This theme of common success is an important milestone for the laboratory industry. It demonstrates that the paradigm in laboratory management is shifting. That has implications for all laboratories and pathology groups.
New Management Paradigm
It means that a gulf is forming between labs and pathology groups now using Lean–Six Sigma and those that continue to operate using the old management paradigm. Over time, that gulf will continue to widen and create both clinical and competitive advantage to those labs which adopt and use quality management methods. Labs holding onto the traditional management paradigm will find themselves falling behind in a variety of key performance and financial measures.
Along with the universal success experienced by labs now using quality management methods, another common theme emerged at Lab Quality Confab. Laboratories utilizing Lean, Six Sigma, and similar principles are forging stronger links throughout the clinical continuum. Since improvement efforts must be organized to meet and exceed the needs of laboratory testing users, these labs actively engage their users and customers as collaborators in improvement projects.
More Lab Involvement
Such interaction helps the laboratory become a more involved clinical contributor. Lab Quality Confab featured several examples of this development. At Harris Methodist HEB Hospital in Bedford, Texas, having completed multiple Lean projects in accessioning and the core lab, the laboratory is now working with the gastroenterology department and nursing on an improvement project. Similarly, at Mobile Infirmary Medical Center in Mobile, Alabama, a one-week long Kaizen event was conducted with the emergency department (ED), the laboratory, and other hospital service areas to shorten average lab test turnaround times for tests requested by the ED.
From a strategic perspective, Lab Quality Confab demonstrated several other important developments beyond the two common themes just described. There are at least five.
First, the fact that this event could be conducted and draw almost 300 participants is a sign that the quality improvement movement has established deep roots within the laboratory industry. This is further indicated by the fact that many of the nation’s most influential laboratory organizations are actively using some type of ongoing improvement program, often based on Lean and Six Sigma methods.
Second, Lab Quality Confab attracted attendees from across the globe. People came from Argentina, Australia, Brazil, Canada, Sweden, and the United Kingdom. The willingness of these individuals to travel across oceans to learn and network with other quality management practioners indicates the depth of commitment that Lean and Six Sigma engenders.
Third, individuals actively using Lean, Six Sigma, and other improvement techniques are ardent learners. Sessions conducted by IVD manufacturers and lab management consultants were well- attended and the exhibition was a beehive of activity. One conclusion is that the shared interest in mastering the tools and techniques of improvement becomes a bonding element for lab vendors and their customers.
Fourth, collectively, the 50 presentations provide powerful evidence that the benchmark for acceptable laboratory performance will be radically increased. For example, At PAML (Pathology Associates Medical Laboratories) of Spokane, Washington, the performance of its 120- courier logistics department has been improved to 5.2 Sigma. That’s about 80 defects per million events.
Similarly, after a negative incident with irradiated blood products, Fairview Health System of Minneapolis, Minnesota, initiated a Lean project that involved the laboratory and included all staff involved in handling such blood products across eight hospitals. The resulting improvements, including standardized procedures, caused the number of incidents involving wrong blood products to drop to zero over the past 18 months.
My point here is that, as labs using Lean, Six Sigma, and other improvement methods achieve these kinds of remarkable improvements, it raises the bar for the entire laboratory industry. Thus, the ongoing adoption of quality management systems by labs and pathology groups will put pressure on lab competitors to do the same—or fall behind in the drive to increase quality, improve outcomes, and better satisfy patients.
Fifth, laboratory accreditation is about to be transformed by the performance of the techniques of Lean, Six Sigma, and other quality management methods. ISO 15189–Medical Laboratories is already gaining international stature as a platform on which countries are basing licensure and accreditation. There was keen interest in ISO 15189 at Lab Quality Confab for that reason.
First To Learn About Quality
Clients and long-time readers of THE DARK REPORT have been first to learn about quality management systems and the early applications of Lean and Six Sigma in lab- oratories and hospitals in this nation, going back to the early years of the decade. This is still a trend which is not fully recognized across the laboratory industry.
That is about to change rapidly. At Lab Quality Confab, most of the laboratory con- sulting companies and in vitro (IVD) diagnostics manufacturers participating at the conference reported that a growing number of their customers are taking active steps to introduce Lean and Six Sigma techniques.
THE DARK REPORT predicts that Lean, Six Sigma, and similar quality management systems will become ever more common with each passing year. The consistent gains in quality and productivity enjoyed by labs using these methods will likely accelerate adoption of Lean and Six Sigma.
How to Develop Your Lab’s Quality Management Program
AT THIS YEAR’S LAB QUALITY CONFAB, the majority of attendees were experienced and active practitioners of quality management systems such as Lean and Six Sigma. Also in attendance were laboratory managers who have yet to launch a quality management program in their laboratory organization.
For labs and pathology groups preparing to develop a quality management program, there was consistent advice from speakers. To implement a successful and self-sustaining Lean or Six Sigma program, it is necessary to have the understanding and the support of senior administration.
As part of administration’s buy-in, every quality program should have agreement in how improvement will be measured and a specific cost savings target or return on investment (ROI) that will be used to determine if the improvement project achieved its objective.
Lab managers and pathologists interested in Lean, Six Sigma, and similar improvement methods for their lab can find plenty of experts to advise and help them. A number of laboratory consulting companies now have certified practitioners in Lean and Six Sigma. Further, most of the nation’s largest in vitro diagnostics (IVD) manufacturers now offer Lean, Six Sigma, and improvement consulting services.
A good starting point to learn about these resources is www.labqualityconfab.com, where the program speakers and their companies are listed. Also available is another resource. Audio recordings and presentation slides are also available for the 50 sessions, covering a wide range of Lean and Six Sigma projects in clinical labs and pathology groups.