Neuberg-Anand Diagnostics has issues to sort out - Fast

"Copy Exactly" is a manufacturing methodology perfected at Intel decades ago to transfer a process technology from the original laboratory development environment into a high-volume manufacturing environment. Copy Exactly! duplicates the exact manufacturing process at all levels in order to yield statistically similar outputs at all production lines. All Intel fabs, from Santa Clara, CA to Ireland to Israel use the *exact* same process, the same equipment, the same workflow, the same training that is drilled into its workers. In Intel's mantra, consistency, repeatability and very low rejection rates and waste translates to high quality semiconductors and premium prices.

Why is this important in my discussion of a central lab diagnostic company in India? Because it matters: very much so, especially in these times.

We requested a home blood test yesterday morning from Neuberg-Anand Labs for myself and my mother - complete blood count and prothrombin time for self and biochemistry and glycosylated hemoglobin for my mum. This was not our first; in our family, we have used the lab many times before and relied on it for its professionalism and the image of efficiency they have displayed. In other times, they have sent one person for home collections who, even before the Coronavirus environment we now live in, displayed all the usual precautions we routinely expect today in both the in-lab visits and at-home collections. For the home collection, the attendant usually carried a neat, customized, bag that had slots for various things - vacutainer tubes, lancets, cotton, syringes, etc. And a separate bag for biowaste. He would show us the blood collection tubes to indicate it had the barcode sticker with my name on it, date of collection and so on. Payment was all digital.

The lab is generally considered the best in the city I live in with firsts in many areas over the years - radio immunassay, immunofluoroscence and tissue typing, PCR tests, microscopic image capture, immuno histo chemistry, in-vitro diagnostics, automated sample tube labeling, first to use 1,5-Anhydroglucitol (1,5-AG) for blood sugar control, autoanalyzer for chemistry, barcoding in registration, automated sample transport, report kiosk, home collection and sample pick up, pre-analytical process automation, digital pathology, drive-through sample collection, etc. The lab was acquired as part of a consortium of other regional labs in 2019 and rechristened Neuberg Diagnostics.

This time around, they sent two young men: both had face masks and pulled on their gloves before commencing work. So far so good. They had no custom bag of goodies that I had seen before; instead, they had a ziplock bag measuring 6" x 4" from which they pulled out - the vacutainer tubes, cotton, syringe, etc. I watched in some amazement and possibly with a troubled expression. I asked: "You carry all that in that one bag?" The attendant responded "Yes sir; you are the only customer and we take it right back to the lab". I let him do his stuff: he arranged these on the table, efficiently went about finding my median cubital vein, scrubbing the area with an alcohol swab, inserted the syringe and drew blood. Filled up three tubes. Then he withdrew the syringe, applied cotton to the puncture area and asked me to fold my elbow. Showed me the tubes and asked me to check my name. All par for the course; I have been through these many times and knew what to expect.

It's the subsequent action that created doubts in me. All the items, including the waste cotton and syringe, were bundled into that ziplock packet. On enquiry, he said the waste went into a separate bag inside, but I was still flummoxed. These were not normal times, these were Corona times and for a lab to exhibit such casualness was unsettling. Was that ziplock bag used again, with a different customer? Did he refill the ziplock after depositing our samples at the lab and attend to his next customer on his schedule?

Process, process, process

Indians tend to have an easy attitude to standards and process and that's the whole reason for this blog. The large majority of us is either unmindful or ignorant about what standards and process mean or the reason for their existence. When we examine the truly great companies, I have always been convinced it's not just their innovation capability or their product excellence that won them the market. It is their singular, anal, almost fanatically religious focus on how they run their enterprise - from design to prototyping, testing to scaled up manufacture, warehousing to supply chain, branding to product marketing, sales to after-sales, product returns to overall customer experience - that helps them outperform their competitors year after year. Yes, they are greatly innovative but that alone never carries the day: there are countless examples of a better product that never scored. But consistency in every interpretation of the word has worked magic for these companies. That includes consistency in product or service quality, consistency in service delivery, consistency in meeting customer expectations.

The customer has come to build an "image map" in her head of what she expects when she makes the purchase - be it Southwest Airlines, Bose, Apple, Nordstrom, Starbucks or McDonald's. And she wants it met every single time. No excuses, no slipping up. In India, companies are yet to discover the hidden artillery in building these customer expectation maps or at least to relate them to attributes beyond the mere product or service. Have a product at a highly competitive price? Great. Can you deliver an experience associated with this product that stands out? Maybe. Same with services such as a delivery: order booking was good? Ok. Payment happened smoothly? Great. Able to deliver within the stated time every time? Maybe.

The Mantra: Consistency in customer experience

Consistency in the quality of the customer experience is a function of corporate standards and immaculate processes - one that the company has designed, after a great deal of thought and experimentation, and driven down mercilessly via repeated training until they are second nature across the organization. Those are the invisible values. They are also continuously checked for missteps, misalignment, or inefficiency. And changed accordingly. There is no "fly by wire" or "winging it". The funny thing is, none of this is rocket science. But very few companies carry this off with elan and confidence. They generally tend to be the outliers in performance. The easy explanation is that it requires top-level commitment and one that is woven into the cultural fabric of the company. That's where the rubber hits the road and companies find themselves wanting. That culture has to be built in at inception; it cannot be grafted later as several reengineering efforts at large companies - manufacturing, retail, banking, etc - have consistently shown whose genesis lie in other, crowded, and emergency assumptions. The cultural DNA of how things are done at a company exists - or doesn't. They don't respond well to reengineering. But a company can most certainly destroy it.

I will most probably continue my custom with this laboratory; they have generally shown themselves to be good, have had a history of having done better than the rest over the years, have high quality lab standards, a good deal of process even if they appear to have fubbed a few recently. For their sake, I hope they pull themselves up and rectify the problematic aspects of standards and process in their everyday work, especially those relating to dealing with customers. It's too important to have mistakes blow their brand out of the water.

P.S. I sincerely hope the lab does not take this account of my experience on their staff. That would be a shame. Customer feedback, sincerely given, gives a chance to companies to up their quality and help build a superior product-service offering.