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©2016 MFMER | slide-1


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Building a Culture of Quality in your Organization

Deb Hagen-Moe, M.Ed.Education Coordinator, Mayo Clinic

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©2016 MFMER | slide-5© 2017 Mayo Foundation for Medical Education and Research. All Rights Reserved.

Department of Laboratory Medicine and Pathology

DISCLOSURE

Relevant Financial Relationships

None

Off Label Usage

None


What is culture?

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Influencing culture

• Identify mission and core values

• Model desired behaviors

• Share stories

Respect, integrity, compassion, healing,

teamwork, innovation, excellence, stewardship



Quality is…

Meeting the expectations of:• Customers• Organization• Regulatory/accreditation agencies• Other stakeholders

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Patient’s perspective

QualityOutcomes + Service + Safety

Cost

Value =


Quality improvement opportunities

OutcomesServiceSafety

WasteReworkRedundancies

Decrease cost

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Responsibilities for quality

LeadersEmployees


Operations

“Best efforts are essential. Unfortunately, best efforts, people charging this way and that way without guidance of principles, can do a lot of damage.”

W. Edwards Deming

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Our Quality journey…

TODAY

Stages of Quality Maturity

Activities

at the moment

Activities

over time

Quality Control

Quality Assurance

QualityManagement

System


Organization

Customer Focus

Facilities & Safety

Personnel

Purchasing & Inventory

Equipment

Process Management

Documents & Records

Information Management

Non-conforming Event

Management

Monitoring & Assessments

Continual Improvement

Quality Management System (QMS)

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Components of a QMS

Structure QSEs Process QSEs Outcome QSEs

Organization Purchasing and Inventory

Nonconforming Event Management

Customer Focus Equipment Assessments

Facilities and Safety Process Management Continual Improvement

Personnel Documents and Records

Information Management



Strategies for building a quality culture

Documents

Transparency

Communicate

Safety

InvestigateJust culture

Huddles Coaching

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Safe environment

• Pay attention to the details of our daily work

• Communicate clearly - hand off tasks effectively

• Have a questioning and receptive attitude

• Hand-off effectively

• Support one another


Communication Tool

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Coaching


Promote curiosity

See

Solve

Think

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Document management

• Written information/instructions

• Accessible to all

• Document control process

• Management of job aids



Dashboards

• Outcomes

• Service

• Safety

• Cost

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Transparency

Actual and potential customers/patients • Confidence to make informed decisions

Organization • Confirms initiatives implemented/tracks results

Employees• What is expected, what I need to do


Investigate events

Machines

Methods

Measurement

Materials

Manpower

Mother Nature

EffectCause

Cause

Cause Cause

Cause

Cause

Cause

Cause

Cause

Cause

Cause

Fishbone/Cause and Effect Diagram

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Impact/effort grid

Effort

Easy to Do Difficult to Do

Detailed planning and work

Just Do It

Discard/delayJust Do 2nd if impactful

Maj

or

Imp

rove

men

tM

ino

rIm

pro

vem

ent


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Best practices

• Define quality

• Robust Quality Management System

• Make quality part of the conversation

• Coaching vs. fixing the problem

• Event management


Call to action…

What is one action item you can take to build a culture of quality in your laboratory or work area?

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Resources

• Anderson, C. (2013, November 18). What is a Quality Management System? Retrieved February 22, 2017, from http://www.bizmanualz.com/blog/quality-management-system-qms.html

• ASQ Learn About Quality. (n.d). Fishbone (Ishikawa) diagram. Retrieved from: http://asq.org/learn-about-quality/cause-analysis-tools/overview/fishbone.html

• ASQ Learn About Quality. (n.d). Five S (5S) tutorial. Retrieved from: http://asq.org/learn-about-quality/lean/overview/five-s-tutorial.html

• Clinical and Laboratory Standards Institute (CLSI). (2013). Quality Management System: A Model for Laboratory Services. Approved Guideline-Sixth Edition. CLSI document QMS02-A6. Wayne, PA: Clinical and Laboratory Standards Institute.


Resources

• Merriam Webster Online. (n.d.) Culture [Def 5c]. Retrieved from: https://www.merriam-webster.com/dictionary/culture

• Institute of Medicine Committee on Quality of Health Care in America, (2001) Crossing the Quality Chasm: A New Health System for the 21st Century. Washington DC, National Academy Press.

• Quality Progress. (2012). Error elimination. Retrieved from: http://asq.org/quality-progress/2012/02/expert-answers.html

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Deb Hagen-Moe M.Ed.

Education Coordinator

[email protected]

Office: 1-507-284-5186

Fax: 1-507-266-2079

Mayo Clinic

200 First Street SW

Rochester MN 55905

Contact Information