As an undergraduate, I never really considered the importance of quality. Of course in lab practicals I ran controls, but I never considered it, or it’s importance as a process until I got my first laboratory role. As scientists I think we do so much more than carry out methods and provide results, we are guardians of the integrity of those results. I think that is an important consideration when it comes to quality management. The processes involved in which we ensure that integrity is something I wish I learned and appreciated more as a student.
There are different facets of a quality management system. Generally they comprise of people, training and competence, controlled documentation, policies, procedures and processes within a laboratory setting. Every aspect of this process helps to ensure we provide confidence in the accuracy of our results, ultimate because the outcome of those results affects patient care.
One of the best analogies I heard regarding quality came from attending a training session on quality management. At the time I was working for a well known water company as a chemistry analyst. Imagine I had two cars, one of these top of the range cars, a Tesla for example, and I had the same version of said car as a toy made for a child.
Which car would you say was of a superior quality? You’d be forgiven for choosing the actual car as opposed to the toy version, but the answer is quite simply, they are both of the same quality because they were both manufactured according to their respective specifications. So in the context of Laboratory work, the purpose of quality is to ensure that the instruments and methods we employ are fit for their intended purpose.
Staff of all levels are responsible for the implementation of quality across all activities. But one of the things I’ve got into recently is quality improvement. It’s a useful skill for trainees to be able to look at processes within the lab and think about ways to adapt and improve without compromising quality. In my own practice it has encouraged me to think about the needs of the service, and the positive impact it will have for service users and stakeholders.
During my time as a trainee, I’ve had a lot of support and encouragement with my interest in Quality improvement, which has saw me helping to roll out a new method within sexual health services for the direct culture and screening of gonorrhoea, which is set to be rolled out to two other hospitals following its success. It involves gaining approval , research design, carrying out research, and gathering evidence to support your proposal. In this instance I looked at factors that affected the viability of Neisseria gonorrhoea on charcoal swabs as we thought the transport delays, delays in processing, and media use could be affecting the sensitivity of the assay, and whilst NAAT testing was an option, we still felt culture was the best option to monitor anti microbial resistance patterns. Fortunately, I had the skills acquired from university to subject my data to statistical analysis, which served as validation for the provision of sustainable controls to our GU clinic.
The next step for me is to prepare an investigation that can assess the viability of my control organisms under different transport conditions to facilitate the rollout to other hospitals in the area. So, as trainees (technically I’m still a trainee), we can play a huge role in service improvement by critically evaluating the current processes and observing how things are done in other departments.