1) The document discusses approaches to improving quality in medical laboratories through total quality management and patient-centered care. It focuses on reducing errors, improving processes, and meeting customer expectations through accreditation. 2) A key aspect is defining customers as both external patients and internal departments, and measuring service quality according to reliability, assurance, tangibles, empathy, and responsiveness. The goal is consistently high quality at a lower cost through patient-centered approaches. 3) Patient-centered care in medical laboratories means respecting patient values and preferences, sharing complete information, encouraging participation in care, and collaborating with patients on policies and programs. This helps improve outcomes and experiences for patients.

1. Laboratory Quality towards
Patient Centered Care
delivered by
Ravi Kumudesh
MSc (SMgt)/ BSc (Mgt)/ED (SMgt)/Dip (MLS)
President
College of Medical Laboratory Science, Sri Lanka

2. Laboratory Errors
CMLS.SL 2

3. Key Concepts
Total Quality Management
Patient Centered Care
CMLS.SL 3

4. Laboratory Process
CMLS.SL 4

5. CMLS.SL 5

6. CMLS.SL 6

7. CMLS.SL 7

8. Core Concept of Accreditation
CMLS.SL 8

9. Core Strategy of Accreditation
CMLS.SL 9

10. Quality of the Service
Service
Quality
Customer
Perception
Customer
Expectation= –
CMLS.SL 10

11. Who is Our Customer ?
Anyone who receive our services, including:
External Customers
Outside the organization, business customers,
suppliers, partners, end consumers)
Internal Customers
Inside the organization, e.g., other departments,
fellow employees
CMLS.SL 11

12. Health Care as an Enterprise
“Health care … is a moral enterprise
and a scientific enterprise, but not
fundamentally a commercial one. We
are not selling a product. We don’t
have a consumer who understands
everything and makes rational
choices.”
Health Affairs – Volume 20, Number 1 (January/February 2001)
Avedis Donabedian
CMLS.SL 12

13. Service Quality
 The customer’s judgment of overall excellence of the
service provided in relation to the quality that was
expected.
 Service quality assessments are formed on judgments
of:
 outcome quality
 interaction quality
 physical environment quality
CMLS.SL 13

14. Measuring Service Quality
SERVQUAL Model
CMLS.SL 14

15. CMLS.SL 15

16. Quality Service, Customer Perceptions and
Customer Satisfaction
CMLS.SL 17

17. SERVQUAL Attributes for Phlebotomy
 Reliability
 Providing service as promised
 Dependability in handling customers’ service problems
 Performing services right the first time and Providing services at the promised time
 Assurance
 Employees who instill confidence in customers
 Making customers feel safe in their transactions
 Employees who are consistently courteous
 Employees who have the knowledge to answer customer questions
 Tangibles
 Modern equipment and Visually appealing facilities
 Employees who have a neat, professional appearance
 Visually appealing materials associated with the service
CMLS.SL 18

18. SERVQUAL Attributes for Phlebotomy
Empathy
Giving customers individual attention
Employees who deal with customers in a caring fashion
Having the customer’s best interest at heart
Employees who understand the needs of their customers
Convenient business hours
Responsiveness
Keeping customers informed as to when services will be performed
Prompt service to customers and Willingness to help customers
Readiness to respond to customers’ requests
CMLS.SL 19

19. How Customers Judge the Five Dimensions of
Service Quality
CMLS.SL 20

20. Health System Transformation:
Current and Future
Current Future
Variable quality; expensive,
wasteful
Consistently better quality;
lower cost, more efficient
Pay for volume Pay for quality
Pay for transactions Care-based episodes
Quality assessment based on
provider and setting (process)
Quality assessment based on
patient experience (outcomes)
CMLS.SL 21

21. Future of Health Care
 Patients play a larger role, including
involvement in making decisions about the
future of health care
 Innovative, adaptable and very scalable systems
have the potential to become national
solutions
 Health IT makes it possible for doctors to
know how patients are doing over time – and
for patients to engage in new ways – and at
their convenience! CMLS.SL 22

22. Picker’s Eight principals of
patient centered care
CMLS.SL 23

23. CMLS.SL 24

24. What is Patient Centered Health Care ?
“Providing care that is respectful of,
and responsive to, individual patient
preferences, needs and values, and
ensuring that patient values guide all
clinical decisions, It includes listening
to, informing and involving patients
in their care”
CMLS.SL 25

25. “Nothing About Us,
Without Us.”
In Short…

26. Filters
CMLS.SL 27

27. Vision
 The patient`s voice is anchored in all behaviors and
drives all activities of the health system
 A culture of patient-centeredness is self-evident
across the health system and is integrated into
existing health care programs
 Health care programming is built upon the patient-
centered care principles throughout planning,
implementation, and evaluation
CMLS.SL 28

28. Key Components
1. Self-management;
2. Shared and informed decision-making;
3. An enhanced experience of health care;
4. Improved information and understanding
5. Advancement of prevention and health promotion
activities.
CMLS.SL 29

29. Core Principles
1. Dignity and Respect
2. Information Sharing
3. Participation
4. Collaboration
CMLS.SL 30

30. Respect and dignity at phlebotomy
Health care practitioners listen to and honor patient
and family perspectives and choices. Patient and
family knowledge, values, beliefs and cultural
backgrounds are incorporated into the planning and
delivery of care.
CMLS.SL 31

31. Information Sharing at Phlebotomy
Health care practitioners communicate and share
complete and unbiased information with patients
and families in ways that are affirming and useful.
Patients and families receive timely, complete, and
accurate information in order to effectively
participate in care and decision-making.
CMLS.SL 32

32. 10 ways to ensure respectful care for
phlebotomy patients:
1. Treat every patient equally
2. Remember basic courtesies
3. Be present with your patient
4. Get acquainted
5. Understand the patient perspective
6. Communicate with respect
7. Replace labeling with positive solutions
8. Keep personal conversations out of earshot
9. Support a healthy work environment
10. Attend to your own well-being
CMLS.SL 33

33. Patient Participation at Phlebotomy
Patients and families are encouraged and supported
in participating in care and decision-making at the
level they choose.
CMLS.SL 34

34. Treatment factors associated with patient
dissatisfaction
 Discourteous treatment
 More than one needle stick
 No outstanding
 employee identified
 More discomfort
 than expected
 Waiting time >30 minutes
CMLS.SL 35

35. Collaboration at phlebotomy
Patients and families are also included on an
institution-wide basis. Health care leaders
collaborate with patients and families in policy and
program development, implementation, and
evaluation; in health care facility design; and in
professional education, as well as in the delivery of
care.
CMLS.SL 36

36. Phlebotomy service practices and policies
at participating institutions
 Phlebotomists perform other tasks
 Policy on limiting number of needle sticks
 Patient relations course
 Formal complaint procedure
 Patient satisfaction monitored
 Waiting time monitored
 Phlebotomy training course
 Policy requiring patient
 to be seated prior to phlebotomy
CMLS.SL 37

37. Service Quality – Gap Model
CMLS.SL 38

38. General Behaviors Based Service Encounter
CMLS.SL 39

39. General Behaviors Based Service Encounter
CMLS.SL 40

40. General Behaviors Based Service Encounter
CMLS.SL 41

41. General Behaviors Based Service Encounter
CMLS.SL 42

42. CMLS.SL 43

43. Resources
 Institute for Family-Centered Care
 www.ipfcc.org
 Picker Institute
 www.pickerinstitute.org
 Planetree Organization
 www.planetree.org
 South Shore Hospital
 Sandra Geiger, Vice President Performance
Excellence; sandra_geiger@sshosp.org
CMLS.SL 44

44. CMLS.SL 45