Everyone Else

What if we redesign quality accreditation to better include biological and medical research?

What if everyone else raised expectations on biological and medical research quality and safety metrics??

If everyone else agrees to transparent quality and safety standards, we would, too.?

If everyone else sets quality metrics expectations to biological research, medical research grants, research at the bedside, chemical study, military laboratories, social science research planning, and primate research labs, we could, too.

Given the right leadership, everyone else can be the peer pressure of our dreams.

Let's get everyone else together to aim high.

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If everyone else is doing it, so can we.?

It’s a silent self negotiation used for better or for worse. It’s a rationale used to improve, or to justify and stay the same. Sometimes it’s an excuse to sink to less scrupulous levels.

Our world has even built its fractured medical, biological and human health-related research silos around this phrase. There are corners cut, toggled priorities and intentional lack of oversight throughout research phases - including in the laboratory.

And because medicine has not yet embraced care delivery cognizant of human behavior, because healthcare has yet to embrace anticipatory policy around human conduct, there is no international safety net for errors. There is no comprehensive oversight built into any of the fractured research.

Biological and medical research crosses country borders at every step: in data and findings, in medicine, in professional practice or social policies. And research errors also cross country borders: rerouting serious funding because of bad data, delaying preventative medicine (like vaccines) because of falsified science, threatening populations with chemical or biological hazards from research handling mismanagement, supplying medicine without disclosing bias that skewed research conclusions. International communities are affected by biological and medical research, opportunities and threats are a constant, and this reality is serious.?

Opportunities and threats needn’t continue the status quo. They needn’t remain a wait and see game.??Global improvement comes from leading everyone else to set the bar higher with research quality expectations. Any individual in any country can lead everyone else.?

Set the expectation that no laboratory, research project or organization is allowed to stoop to everyone else’s corner cuts. Set the expectation that everyone else is held to standards, and these entities will be as well.

Parrot back the phrase to our global medical research infrastructure, and let the global community know that the phrase now has a benchmark attached. From the cellular entry in the lab to the consent form signed for healthcare delivery research, research quality accreditation should be comprehensive.?

Three immediate paths to improved quality and safety in biological and medical research are clear.? Before we review these three, let’s recall the main ways to achieve healthcare delivery: to provide quality care to people, and to be there when people need us, no matter how many people need us.?

It had been nearly 7 years since I attended a Town Hall meeting at the hospital. Seven years prior, I stood in the doorway after a long spring 2006 shift. The CEO at the podium was sincere, and I was exhausted, and I left after 10 minutes. Today, he greeted me as I took a seat near front row. I supposed that we were both keenly aware of the external and internal winds. Because we were raised and live within the winds, the hospital town hall stayed focused on their objectives. I stayed focused in my heart on supportive ideas for research bridges with healthcare delivery.?

Solid with multiple choice my entire life, I accepted my Town Hall buzzer confidently. This very windy city would undoubtedly observe from afar, so I made my choices deliberate. I decided to send a nod to the past and answer these questions with an NCLEX mind*.

*Nursing license exams have more than one right answer in the multiple choice. Takers must choose the most correct answer. I’m not a fan nor do I support this test style; the profession is a big fan of it, so I roll with it.

This hospital took a chance and hired me even before I held the passing paperwork, and that’s a hard respect to forget. Also, as an acknowledgment to the present winds, I decided to answer the test from a multi-employer view. Fair is fair, in mock and justice.

Question 1 presented as my homage opportunity without delay.?

"What is the hospital’s main mission with patient care??"

Choice D, C. Both of those were correct with interpretation. ??

D: to provide the highest quality of care. C: to see as many people as we can.?

I thought about the current 2013 wind, one that likely carried the mock airborne, and I thought about the emergency response weathering I’d just taken. As a nod to true trauma and emergency response, I chose C. The correct answer was D, obviously.?

Looking around the undivided room brought reflection. Sure, I hoped that they had observed my tracker. Yet, what I wanted then, also what I wanted upon departure less than a year later, was clear: for team conformity to lift and raise standards. For team conformity to set the bar higher on transparency, on urgency to mock wrap-ups, on priorities with medical innovation in the delivery setting. For team conformity to appreciate individualism, yet strive to uphold standards in values. For team conformity to not sink to any unscrupulous agenda of everyone else. For team conformity to expect more.

And I wanted to see the end of the fall back buzz lesson in healthcare: the way we’ve always done it.

Three immediate paths to improved quality and safety in biological and medical research are clear.??

1. Acknowledge and accept the culture in research as it is.?

The way we’ve always done it isn’t the way we should do it is a public relations wash. Group conformity is given a pass with this buzz phrase.?

Group conformity doesn’t change when addressing the old ways versus new, because group conformity isn’t challenged to address vices or behaviors. When group conformity cares less about how we’ve always done it and more about what the group can get away with because everyone’s doing it, the buzz phrase is rendered useless.

Instead, we should be stating that if everyone else is doing it, everyone else must be setting better expectations. If everyone else is substandard, and why we are settling on being like everyone else.?

It’s important to acknowledge and understand where biological and medical research is. Once we understand the current situation with quality and safety metrics, we accept and move forward. A great start would consider:?

• Who is everyone else as defined by a country or association in that country? Who are they aligning with, in expectations or in corner cuts???
• What credentialing and accrediting bodies are chosen, and why are they chosen?
• What is the evidence or threat assessment white paper references to guide current expectations??
• Who enforces the credentialing and accreditation failures?
• Who follows up with serious concerns??
• How is the private philanthropy and industry funding for laboratory, biological and medical research tied to quality and safety metrics? How is any funding stream accountable and how does the funding hold the research accountable?

The real issue is not the evolving way we’ve always done it. Healthcare changes continuously and the ways we do things change, too. The real issue is the unchanging constant: if some in healthcare can get away with something, many others slide down to that level too. This is true for scope of practice restriction that demands supply, scope of practice negligibility that risks quality, reimbursement and billing maneuvers, marketing practices, industrial factory concepts of risk, pharmaceutical agenda that excludes certain priorities. It’s even true of wind. Sometimes if everyone else is doing it, the players in these healthcare arenas can, too.

Acknowledge, accept and understand the comparisons of everyone else to get a handle on global biological and medical research quality oversight.??

2. Determine similarities, opportunities, gaps and a path forward.?

• Bring in nonprofits and research association advocacy currently focused on quality accreditation. Bring them to the table.
• Identify structures and accrediting bodies in place, and establish consensus on details.?
• Compare current credentialing and accreditation use.
• Compare regulations around accreditation as well as certification.?
• Assess for redundancy or duplication.
• Compare current metrics to evidence or threat analyses.?
• Identify gaps and opportunities for standardization
• Clarify the limitations of international resolutions and clarify the limitless opportunities in regulatory and trade enforcement.?
• Determine oversight responsibilities and enforcement capabilities.?

3. Advance a united front for secured research quality and safety.?

• Commit to move forward. Establish key partners, stakeholders and timelines.
• Be realistic. Individual entities, states, professional bureaucracy, country laws, geopolitics may hinder some efforts. However, these arenas are all dependent on healthcare and healthcare economics are dependent on the public. So, be realistic about the feasibility with a firm stance.
• Move paced. If small moves are to be made, pause for celebration and then add more success. It is no longer enough to look back on some UN resolution, unenforced and pending, from years ago. Don’t just move to start, move to the finish line. Get the job done, paced.???

The time to get the details right is now. That can be paced, too, even over several months. And the finish line sets the stage for everyone else to get on board.

For the caution and the hand to hand assist with everyone else concepts for loved ones all over the world in other lines of work, still bonded to me, feel free to check out my Medium words.

The words here reflect that this is my profession, biological innovation and healthcare delivery is my everyone else, and I'm ready to help walk the walk with these others.

Readers of this publication can choose to absorb the content, pivot and find the writer's confidence cute. Readers may feel urgency in wondering if she'll end up with that San Francisco sweetheart or another new guy.

And readers should know that, like the 2013 hopes on group conformity, the 2016 What If article on quality accreditation improvement has only been strengthened. Distracted, diverted years since have only brought about a sharpness to focus.

And when it comes to any status quo or temporary excuse to cut corners? We can take heart that this too shall pass.

Global research quality improvement comes from a benchmark that all are accountable to: academic medicine research buildings, social science research grants, military labs, academic medicine clinical labs, primate labs.?

And global standards in research, from lab to bedside, will help us open the door for everyone in need of healthcare, no matter how many people need healthcare, with best quality assured.

The excuse of everyone else is doing it can be parroted and flipped. Given the right leadership, everyone else is the peer pressure of our dreams.

Let’s aim high.