Interested in learning more about building a quality culture? The CAP’s QMEd™ Quality Culture online course will provide you with an adaptable program

for your laboratory. It includes video commentary by experienced CAP assessors as well as CAP member pathologists who are recognized for having positively influenced the culture of their organizations. Earn four CE credits with the completion of this course.

For more information, visit cap.org and search QMEd™.

Building a Culture of Quality

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Change LeversGoalProject Approach

Create Team

Assess Current State and Desired State

Find Root Causesof Current State

Assess Readiness to Change

Develop Action Steps

Implement Action Steps

Monitor and Maintain

Planning

Implementation

Effectiveness Check

Culture of Quality

• Innovation

• Speaking Up

• Going Above and Beyond

• Transparency

• Process Orientation

• Teamwork and Involvement

• Risk Awareness

Environment of Connection

• Respect and Appreciation

• Trust

• Confidence/Lack of Fear

• Community and Common

Purpose

Communication

Recruitment and Selection

Training and Development

Reward and Recognition

Rituals and Programs

Visible Leader Actions

2

3

4

5

6

7

Culture of Quality–Key Dimensions

Dimension of Culture Example Behaviors

Innovation • Question the status quo, question assumptions, and support change

• Support staff who make suggestions

Speaking Up • Speak up about problems• Speak up when processes are cumbersome and

will likely result in a workaround• Listen to staff when they raise issues

Going Above and Beyond • Do more than is required, striving for higher levels of quality, continuous improvement, and achievment • View occurrences as useful – as opportunities

for learning and creating improvements

Transparency • Report errors and near misses to supervisors and managers

• Support staff and encourage them to escalate errors; reward and recognize those who come forward

Process Orientation • When investigating mistakes, ask, “How did it happen?” rather than “Who did it?”

• Respond to mistakes by looking for a process cause

Teamwork and Involvement

• Include front line staff in decision making• Use cross training and job rotation to help

individuals learn the perspective of other groups• Treat everyone as a valued team member

Risk Awareness • Proactively look for risks in the environment• Ask questions of leadership when something

doesn’t seem right• Trace QC and PT anomalies to their root cause

RISK