Volume 37 Number 3 | June 2023
Kristen Croom, MBA, MLS(ASCP)CMMBCM, FACHE, ASCLS Board of Directors
I recently attended an education session about high-reliability organizations (HROs) and how many healthcare organizations use these concepts to reduce patient harm. A key concept in HRO is standardization by applying proven strategies that exhibit consistent outcomes. These strategies are evidence-based and supported by peer review research. As laboratory professionals, we deal with standardization daily. Standardization ensures that SOPs are followed, results are accurate, and the patient receives the best care.
Another aspect of healthcare is personalization, which focuses on an operating environment where flexibility drives greater accountability and maintains equilibrium among the wants and needs of all partners within the healthcare system. These two concepts can work well together if the right individuals develop the necessary skills to succeed.
The only way for this to work is through teamwork. As a healthcare team, we each have certain specialties and expertise that allow us to see a part of the whole picture. An effective team will acknowledge these perspectives and decide on the best course of action.
“An effective team will always consider the standardizations and realize that each situation is unique and may require personalization to meet the needs of our patients and partners.”
An example I have from my lab was when a large point of care testing (POCT) vendor pulled one of its tests off the market because of an FDA approval withdrawal. We had to quickly decide our next steps for our Level 1 Trauma Center and the other three smaller hospitals in our system. Our internal laboratory team was not on the same page and did not communicate effectively before the large multi-disciplinary meeting. This became apparent during the meeting and created delays, damaged relationships, and, ultimately, a loss of credibility for the lab team. This failure pushed me to create a system wide POCT team centered around communication and appreciation of our different strengths and perspectives.
When the FDA sent another letter to the same company, and it looked like we may be in the same situation again, this POCT team came together, had an honest and open discussion, and created a plan without the necessary drama this time. An effective team will always consider the standardizations and realize that each situation is unique and may require personalization to meet the needs of our patients and partners.
As a new laboratory leader, one of my struggles was promoting teamwork and honest communication during a crisis. This is why my first attempt at addressing the POCT issue was a disaster. I was not listening to everyone’s perspectives, only those that fit mine. While I’m not perfect, I have worked hard on these interpersonal skills to be aware of my presence as a leader and how that affects my team and their willingness to speak up. I highly recommend reading Five Disciplines for Zero Patient Harm, by Charles S. Mowll, on HRO and building effective, accountable teams.
Kristen Croom is Director of Labs at The Queen’s Medical Center in Honolulu, Hawaii.