Tools, Technologies and Training for Healthcare Laboratories

The Journey, Not the Destination

The Westgards traveled all over the world in 2010. A year end perspective on what they saw.

The Journey, Not the Destination
Looking back on 2010 and forward to 2011

James O. Westgard, PhD and Sten Westgard, MS

December 2010

The year's end is rapidly approaching and it's our annual moment to catch our breath and take account of all that has happened. Amidst a global recession, notable instrument problems, and the continuous struggles to keep quality on the laboratory agenda, we nevertheless have reason to be grateful and optimistic this year.

We were particularly pleased to have the support of AACC and the Coulter Foundation for the publication of our book Basic QC Practices in Spanish.  It also prompted us to update the materials and get a new 3rd edition out in English.  We continued to work on new materials for Risk Management and now have two course modules available on our website, the 1st an introduction to Risk Management, and the 2nd a review of ISO and CLSI guidelines that influence the practice of Risk Analysis.  A 3rd module on “Methodology and Tools” will become available next year, along with a new book that will be introduced at our 2011 June Madison workshop on “Six Sigma Risk Analysis.”

We have been very happy to have your active interest in Westgard Web.  The website now has over 15,000 members, more than half of them outside the US (in over 50 other countries).  We had over 300,000 unique visitors this year, a total of over 500,000 visits, over 4 million pages visited, over 25 million “hits”, and almost 300 GB of data transferred.  For a “niche” website, we have a very loyal following throughout the world.

We also have had a chance to meet many of you in our travels this year.  Between the two of us, we traveled to five continents, more than a dozen countries, more than 30 cities, and gave close to 50 lectures. There is a saying that “quality is a journey, not a destination.”  We hope that we are fellow travelers with you on that journey.  Our experiences support that finding.  The audiences for all these events number well into the thousands. Of all those people, few of them expressed a lack of interest in quality. All of them are challenged, but still there is a strong professional ethic that persists. Unlike the traders and bankers of Wall Street, there is still a desire to do the right thing, not just the most profitable thing.  When you think about the ethics and practices of different professions, laboratory professionals rank much higher than those in other services such as finance, banking, law, and politics.  In these difficult times, the people who work in the laboratory are especially admirable.

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Sten in Warsaw, Poland in December.

While good people are the foundation, there continue to be issues with quality due to poor analytic systems, inadequate regulations, incomplete guidelines, wasteful processes, and wrongful practices.   Nonetheless, there is still room for hope. A recent book about Beethoven - The Ninth: Beethoven and the World in 1824, by Harvey Sachs - highlights this reason. The book describes the debut of Beethoven's famous 9th symphony, on May 7th, 1824, especially the soaring chorus in the last movement, extolling mankind to universal brotherhood and "to Joy." This symphony is so famous that it has been played at the fall of the Berlin Wall and frequently serves as the opening theme for the United Nations or a new concert hall.

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Dr. James Westgard with Dr. Bert Malkus of Yale-New Haven Hospital.

But when we listen to the 9th symphony today, we hear something far, far better than what the original listeners heard. At the 1824 debut, the orchestra was a mixture of semi-professional musicians along with "pick up" musicians and singers. The orchestra and chorus had only rehearsed the symphony together twice. The music itself was hand-copied and hard to read. They were not playing in a dedicated concert hall (those didn't exist yet in Vienna), but instead were hiring the opera hall for this occasion. The audience, in that time, was also not as quiet and attentive to the music (mannered silence at symphonies is a more modern development). And famously, Beethoven's deafness was near complete by this time, to the point that he didn't hear the audience as it gave him an ovation for the symphony.

Despite all these handicaps, imperfect instruments, imperfect musicians, imperfect sheet music, imperfect audience, and an imperfect composer, this symphony went on to become one of the touchstones of Western music. The 9th symphony we hear today is played on better instruments, by better musicians, with better conductors, and can be heard on CDs that provide better sound. (It is said that the CD itself was designed to hold 73 minutes of music because that is just long enough to hold a complete performance of the 9th symphony.) The 9th started out humbly but has reached greatness.

We in the laboratory can commiserate with those 19th century musicians. We often have imperfect processes and often do not possess all the skills and training that we might like to have. We have different instruments, yes, but they still are imperfect, and we try to bring out the best from them, something that can be in harmony with our audience, the patients.

Perfection may not possible, but we still make the effort, dedicating ourselves to improving things just a little bit better each time.

Here's hoping that your 2010 was good for you, and that 2011 will be even better.

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Sten and Jim at the Williamsburg CLMA Tidewater chapter workshop

Best Wishes,

James and Sten