Posted on Apr 5, 2016
Dr. Carolyn Shiau, a pathologist working out of Royal Columbian Hospital (RCH) was tired of hearing “because that’s the way it is always done” when looking to make improvements.
In April 2015, she joined the Physician Quality and Regional Safety Team (PQRST) – an initiative funded by SSC to support physician engagement through quality improvement in Fraser Health.
Through educational sessions with the Chair Dr. Curt Smecher (Anesthesiology, Abbotsford Regional Hospital), she learned how to create measures to monitor change through continuous cycles of quality improvement, and how to approach technical staff and senior colleagues with ideas for change.
Armed with these skills, Carolyn set out to improve the quality of histology slides in the lab and improve the percentage of routine cases completed based on regional benchmark turn-around time.
Through rounds of process evaluation, slide quality improved so dramatically that pathologists began to require fewer slides to make a diagnosis. In addition, the bench technologists generated ideas for improvement. Everyone was encouraged to be open to testing an idea for at least one to two weeks before accepting or rejecting it. Weekly meetings saw robust debates between technologists and pathologists that helped create open communication.
In August 2015, with Carolyn’s guidance, the lab revised their priority sequencing of cases through a shift in schedules. Now instead of completing 20-25% of routine case within 72 hours – the lab is completing 75-85% - maintaining this result with no increase in staff and no delay with complex cases. For the clinicians, this helps improve patient flow and it takes less follow-up visits to review results. Today, the culture in the laboratory is one of openness to change and “Let’s give it a try”.
For more information on PQRST, contact Aman Hundal, SSC Initiative Lead, ahundal@doctorsofbc.ca or for more specifics on FH’s PQRST, contact Dr. Dayan Muthayan dayan.muthayan@fraserhealth.ca
