The Westgard Rules

Labs: Lean to the bone?

Posted by Sten Westgard, MS

Here's a brutal return to reality from the celebrations of LabWeek.

The April 2010 CAP Today inside cover story is titled, "Thanks to weak economy and more, efficiency is king." It's not a surprise that laboratories are trying to cut costs again, but there was one paragraph that jumped out at me. The first interview is with Heidi Riggenbach, CLS, MT(ASCP), the lab director of a small hospital. She describes staff layoffs and 10-hour shifts, things that are becoming the standard practice of this era, but then she notes that even that is not enough:

"Why not pursue the cost savings said to stem from Lean principles? Though Riggenbach admires the Lean philosophy, she doesn't think it's practical to implement in her laboratory: 'When you're this small, it's really hard to Lean down anymore, because you just don't have the space to do it with. I know a lot of labs have done Lean, and that's great, but most of the ones that have gone through major changes like that have been able to remodel at the same time.'"

Riggenbach goes on further to explain how her staff is now rearranging the layout of the laboratory equipment, seeking even slight improvements in efficiency that might be gained by the right permutation of instruments.

Riggenbach is one of the unsung heroes of the new laboratory economy, an Atlas on which everything rests. She's cut all she can cut, laid off all she can lay off, and still she tries harder, Lean-ing every last bit of speed out of her laboratory. The chronic malady of labs is cost-cutting.

Labs are Vital, to be sure. But Vital Signs of these Labs seem more frightening by the day.

Isn't it time to start investing in labs and the people who run them?

Lab Week: The Savings

Posted by Sten Westgard, MS

LabWeek is not only a celebration of laboratory workers, it's an excuse for a sale (see: memorial day, labor day, president's day, etc.)

We're not immune from the temptation. So here is our special for laboratory customers:

Use the coupon code LABWEEK in our online store at http://www.westgard.com and save 20% off all books, courses, and even workshop registrations!

[The Fine print: offer ends April 25th, online store orders only; only one coupon per customer; cannot be combined with other discounts]

Lab Week: Thank YOU, Laboratorians

Posted by Sten Westgard, MS

This LabWeek celebration, I was thinking back more than three decades ago to my childhood. Back when I was in the single digits, one of the special treats for the Westgard kids was going to visit my father at the hospital laboratory.

Now, don't get me wrong. We didn't go into the actual labs and tinker with the benchwork. But we did walk through a maze of hallways to find this hidden place (it seemed like it was hidden away at the time) where my father worked. We would stop in his office, and if we behaved ourselves, he would reach into the drawer where he kept sweets and let us have a treat.

In the hallways, each door had a little window in it. So we could wander a bit, peek inside and see all the people with white labcoats on. Serious people. Doing important work. At the time, I didn't understand just what kind of work was being done in the laboratory. But my father was proud of the work being done and he impressed that upon us.

So I guess even from the youngest age, I knew that laboratories were special places.

Now, in the years since, I have learned a lot (a lot!) more about what goes on in the laboratory. The past eighteen years working with my father has taught me a great deal about testing, quality, and the impact of quality on patients.

More viscerally, I have experienced the impact of test results on my children, my family, and my friends.

So, for all of you doing this important work, Happy Lab Week, and please accept the personal thanks from all the Westgards for doing what you do.

Errors about how much error is acceptable

Posted by Sten Westgard, MS

Alan Greenspan gave some instantly notorious testimony to the US Congress recently:

“I was right 70 percent of the time, but I was wrong 30 percent of the time,” 

I'm not sure what was more concerning; the fact that he admitted that almost a third of the time he was wrong, or that he clearly believes that being right only 70% of the time was acceptable. Clearly, for a man once called "The Oracle" and Maestro, he was lowering the bar on the standards for judging him.

Testimony like that raises some instant questions:

• If Alan Greenspan was responsible for setting the direction of the world's greatest economy, is a 30% error rate acceptable?
• If Alan Greenspan was an airline, would you fly him?
• If Alan Greenspan was a core laboratory test, would you buy the instrument?
• If Alan Greenspan was a glucose meter, would you buy the device?

Why Workshop with Westgard?

Posted by Sten Westgard, MS

We've probably never met before.

Maybe you're a reader of this blog. Or a visitor to the website, like the tens of thousands of laboratory professionals who visit the website every month, accessing hundreds of free articles, lessons, and examples of quality control. Or perhaps you're one of the thousands who have taken our online courses or purchased and read our many books and reference manuals.

But it is highly probable that we have never talked, emailed, or had a discussion with each other.

And maybe that's not good.

New Biodatabase update from Ricos et al

Posted by Sten Westgard, MS

For over a decade, Carmen Ricos and her colleagues have scoured the scientific literature, seeking out new studies of within-subject biologic variation. Then they have taken that data, assimilated it with what is already known, and calculated desirable specifications for imprecision, inaccuracy and allowable total error.

What's even more amazing is that they then make this available to the public.With great generosity, they have allowed us to post the updated database every two years. So now, for hundreds of analytes, many of them not covered by other guidelines, there are scientifically derived, "evidence-based" goals for analytical performance.

The Ricos et al biodatabase has always been one of the most popular resources on the website, and rightfully so.

Perhaps I am overstating it, but I think this is a great public service. I don't know that awards are given out for such things, but surely Ricos and her colleagues deserve some praise and more.

Here is the updated biodatabase:

http://www.westgard.com/biodatabase1.htm

And a quick list of the newest entries and modifications:

http://www.westgard.com/biodatabase-2010-update.htm