One thing to remember when addressing quality issues in the lab is to find a root cause. If the same mistakes are being made over and over by both techs, then that isn't a personnel problem that can be fixed with rewards/punishment. That is a process problem. You need to review you processes and will likely find the root cause for your errors there.
Regards, Sent from my iPad On Dec 19, 2012, at 2:17 PM, Kim Donadio <one_angel_sec...@yahoo.com> wrote: > Id like to add my 2cents to the measuring "Quality" topic. I'll make it > short. > > You should have a "Quality Managment" program. It's vital to track errors, > trypes of errors, frequency and who etc. This is NOT a tool for blame as we > are all adults or we should be. It is however a tool for tracking trends, > making improvments and yes if you did see someone making a mistake often, you > would have the data to educate particular personel. > > There are QM tools out there from various organizations. And yes, there are > standards of deviations such as the TAT for frozens. There are standards for > other thangs as well. Set Standards of excellence with your Pathologist. Make > goals. Track them. Follow improvment. > > So try a google on QM and see if that helps answer any of the original > questions. > > BTW... Merry Christmas Histonettters. :) > > Kim :D > > ________________________________ > From: "O'Donnell, Bill" <billodonn...@catholichealth.net> > To: Maria Mejia <mbmph...@gmail.com>; "Morken, Timothy" > <timothy.mor...@ucsfmedctr.org> > Cc: histonet@lists.utsouthwestern.edu > Sent: Tuesday, December 18, 2012 2:37 PM > Subject: RE: [Histonet] Basis for Quality Work in a Histotech > > Maria - Well said. > > -----Original Message----- > From: histonet-boun...@lists.utsouthwestern.edu > [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Maria Mejia > Sent: Tuesday, December 18, 2012 11:36 AM > To: Morken, Timothy > Cc: histonet@lists.utsouthwestern.edu > Subject: Re: [Histonet] Basis for Quality Work in a Histotech > > Travis, > > I agree with everyone's valuable thoughts regarding your question. As a > supervisor, it's imperative to communicate with people in such a way that > they change themselves. > With some people the act of "getting the task done," has such an urgent > need that can lead them to become careless & aggressive, leaping before > looking & even speaking without thinking first. In histology, we know it's > more important to avoid making mistakes - to be certain every detail is > accurate & in place. And, it's important to find the balance between the 2 > intentions of "getting the task done" & "getting it done right!" > > It's also important to create & develop relationships with those you work > with. The desire to contribute to others & be appreciated for what you do, > is one of the most powerful > motivational forces known. And yes, sometimes you get what you give! Giving > appreciation & getting along with others go hand-in-hand - & as a supervisor > it's another balancing > act. Also when people have the same priorities, a misunderstanding or > conflict is highly UNLIKELY. > > All the best > Maria Mejia > San Francisco, CA > > > On Dec 17, 2012, at 8:30 AM, Morken, Timothy wrote: > >> Travis, >> >> Histology has a very complex workflow AND requires "artisan" level >> workmanship to deliver a product. Those two together nearly guarantee >> mistakes, mostly minor, but sometimes literally life-threatening to >> patients. The goal is to instill a sense of Best Quality in the techs. A >> large part of achieving that attitude is to ensure the pathologists and >> administrators are behind the techs 100% and ALLOW the techs to do Best >> Quality - ie, accept that Best Quality will sometimes mean slower turnaround >> time. Does that aspect mean more people are needed? That's your call, but >> can be determined by workload accounting. >> >> The attitude should be that the SYSTEM makes the mistake, not the >> individual. It is not likely a person makes a mistake on purpose, but >> instead is it some aspect of the system that allows them to make a mistake >> (though "shortcuts" can be thought of as intentionally risking making >> mistakes "on purpose," the "purpose" being to save time or effort). >> >> Workflows can be "engineered" to ensure some mistakes don't happen. >> Protocols must be followed to the letter by EVERYONE. No workarounds allowed >> (a workaround is an indication that there is something wrong in the system - >> the employee feels the need to take shortcuts. Why? BTW, Bill Gates said >> the most important word in his vocabulary is "why." Why is something done >> the way it is? Why does a mistake happen at a certain point? ). In failure >> analysis a problem is approached by asking 5 levels of WHY? After asking WHY >> 5 times back down the workflow chain you usually find the root cause of a >> problem. If not, you keep asking why until the root cause is found. >> >> For instance, we worked out a slide labeling protocol at the microtome that, >> if followed, will ensure the tech does not make labeling errors. All >> participated in working this out and so have bought into the system. All new >> employees are trained in that system. That will eventually be followed by >> barcoding, but that is a year away at least. But our protocol has nearly >> eliminated labeling errors (we still get a few sneaking in here and there >> but as we catch them we try to figure out how to engineer them away). >> >> We also finally instituted the printing of cassettes directly from our LIS >> rather than using a stand-alone printer or hand-writing. That has almost >> totally eliminated cassette labeling errors - we used to have hundreds per >> month, mainly by residents putting in cassettes that they did not enter in >> our LIS, or making simple typo errors on a stand-alone cassette labeler, or >> hand-written cassettes. >> >> All these methods need to be investigated. >> >> Rewards are also very helpful. We give out "Bear hugs" that are $5 gift >> certificates to the campus store, cafeteria, various food vendors in the >> institution, etc. it's a small reward, but people actually appreciate it. We >> also have "Star Awards" of $50 gift cards for those times when someone does >> something more beyond the usual. The receiver chooses the card they want >> from about 2 dozen available (coffee shops, VISA, various stores, etc). >> >> >> Good luck with it! >> >> >> Tim Morken >> Supervisor, Electron Microscopy/Neuromuscular Special Studies >> Department of Pathology UC San Francisco Medical Center >> >> >> >> >> >> -----Original Message----- >> From: histonet-boun...@lists.utsouthwestern.edu >> [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J >> Buesa >> Sent: Saturday, December 15, 2012 8:38 AM >> To: Travis Troyer; histonet@lists.utsouthwestern.edu >> Subject: Re: [Histonet] Basis for Quality Work in a Histotech >> >> First I want you to excuse me, but I do not think that you are really >> qualified to supervise 2 histotechs if you need to ask for such quality >> guidance. >> You end by bemoaning about "budget crunch" and because of that it seems to >> me that your 2 histotechs are not receiving a "decent" salary and, as >> everybody knows, you are getting what you are paying for. >> With 10 years of experience you should know that the first step for quality >> of sections is quality of fixation and quality of processing. You have first >> to manage that aspect. >> Quality of sections comes after wards and there is no "standard" for >> mistakes and for what you are describing it seems that mistakes are >> frequent. By the way, if the pathologists are not pleased, they will not it >> take on the histotechs, but on you as a supervisor unable to provide them >> the quality they require. >> There is no such thing as "instant reward" for a good quality job; the >> histotech should not be treated as "dogs receiving a cookie after a trick >> performed" but there are 2 tools: you need to keep track of the mistakes → >> counsel the HT after a mistake → retrain them → keep a track of mistakes and >> there are verbal and written counselings and an annual evaluation, I am sure >> you know that. >> The ideal limit of mistakes is "0" but there is some acceptable mistakes >> limits, as long as they are few and far between. The pathologists are the >> ones who can tell you what they are willing to accept as mistakes limits. >> Ask them. >> It seems that if your 2 HTs do not improve, you should start looking for >> replacements, but they should be better paid, and if the mistakes continue >> at a high rate, you should put your 10 years experience to work and start >> doing some bench work René J. >> >> >> From: Travis Troyer <ttro...@petersonlab.com> >> To: histonet@lists.utsouthwestern.edu >> Sent: Friday, December 14, 2012 5:34 PM >> Subject: [Histonet] Basis for Quality Work in a Histotech >> >> This is a question for all of the lab supervisors. I am the supervisor of >> two histotechs. I am not doing techwork now, but have 10 years of >> experience. The pathologists are getting more and more upset at the lack of >> quality in the work and the mistakes that are happening. I was wondering if >> anyone had some ideas on what sort of a goal to set up and how to >> reward/punish for variations from that goal. For example, if the goal is >> three mistakes for the month, what is the best way to reward them for making >> that goal and what would be best if they had more mistakes in a given time >> frame. We are all feeling the budget crunch and the pathologists are trying >> to figure out a good solution. >> >> Thanks, >> Travis Troyer >> _______________________________________________ >> Histonet mailing list >> Histonet@lists.utsouthwestern.edu >> http://lists.utsouthwestern.edu/mailman/listinfo/histonet >> _______________________________________________ >> Histonet mailing list >> Histonet@lists.utsouthwestern.edu >> http://lists.utsouthwestern.edu/mailman/listinfo/histonet >> _______________________________________________ >> Histonet mailing list >> Histonet@lists.utsouthwestern.edu >> http://lists.utsouthwestern.edu/mailman/listinfo/histonet > > > _______________________________________________ > Histonet mailing list > Histonet@lists.utsouthwestern.edu > http://lists.utsouthwestern.edu/mailman/listinfo/histonet > > This electronic mail and any attached documents are intended solely for the > named addressee(s) and contain confidential information. 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