I’ve heard it said that continuous quality improvement (CQI) is for laboratory staff – to improve their processes so that slides or results reach pathologists in a timely manner. From there, the pathologist can undertake the interpretation and write the report for clinicians. But I don’t believe CQI is the exclusive domain of non-pathologist laboratory staff; I firmly believe that CQI is for pathologists, too.
Reporting is a process. For me, it involves continuously asking, “Is what we are doing the best way of doing it for the clinician and the patient?” For instance, how do we decide which case to report first? What steps are involved? Are any steps duplicated – and, if so, why? Could technology be used to speed up the reporting process? How could we minimize frustrating defects, such as histology slides needing deepers or blood tests needing to be repeated? Could the pathologist coordinate an improvement project with the lab staff involved to minimize the defects that carry the greatest time costs? Is my office tidy enough that staff who need to find slides for multidisciplinary meetings have a chance of locating them? Could we implement a system of colored trays to make their job easier and quicker – thus giving the pathologist more review time?
It’s important to ask questions like these about every step of every process in the laboratory. So how can you and your colleagues get involved? The Royal College of Pathologists have launched the first annual CQI Awareness Month in May 2019 – and they’ve created several activities to help. These range from podcasts, in which pathologists who have experience of CQI tell you what they learned in the process, to a social media challenge in which participants apply the Lean 5S process to their own workspaces (#5SMyDesk). The organization is keen to help pathologists and laboratory medicine professionals move toward CQI, so it’s also offering CQI mentoring, audit certification schemes, and a variety of online resources and workshops.
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