The other day I was chatting with a friend who said he had lost count of how many times I had retired over the last few years. Another friend asked if I might consider retiring from retiring. I see it a little differently.

I have always enjoyed being actively involved with healthcare through medical microbiology and infection control and teaching. Getting connected to proficiency testing was a personal discovery lead me to the personal satisfaction being engaged with the discipline of Quality Improvement, both nationally and internationally. Developing and growing our Clinical Microbiology Proficiency Testing program (CMPT) and our Certificate Program for Laboratory Quality Management (POLQM) was intellectually stimulating and emotionally satisfying. At a certain point I decided to make some choices, and focus my attention on the CMPT and POLQM, because they offered the opportunities of outreach and education.

Both programs became strong international successes, but I was concerned they might disappear when the time came for me to retire from our department, so with the support of Don Brooks, I sought out an opportunity to find my replacement. After going through the process, Dr. Lucy Perrone joined our department as the first Dr. Donald B Rix Professor in Laboratory Quality in April 2022. By June, it was clear that she had everything in hand and was working well with our staff and had a thousand brilliant ideas on how to make the programs bigger and better. It was time for me to get out of her way and for me to move on with my own path.

For many years we had understood that through our Clinical Microbiology Proficiency Testing (CMPT) program we had created a valuable model for proficiency testing for microbiology laboratories in countries other than Canada. Towards that end, we developed our proficiency testing training program so that other countries interested in learning our techniques could send people for a ten day experience at CMPT in Vancouver to learn from our staff.

Kenya Training September 2022

Over the years we had people come from about 10 countries from Africa and Asia and Europe and the Middle East with a lot of success. But along the way we found there were organizations that wanted and needed the training experience, but travel to Vancouver was far beyond their budget. For many, their only sources for external assessment of their laboratory performance were international programs from large providers, but many the samples received were not consistent with the challenges experienced in their own country, and transport costs and delays made the programs not very effective. The assessments they received were neither helpful nor relevant to their laboratory practices.

Our solution was to help them set up their own programs with their own staff and challenge bacteria. By taking this approach they could become engaged in Quality Assessment, reduce costs, reduce international importing, and increase national relevancy. Working with Daniel Taylor and Mark Frass of Oneworld Accuracy, an international proficiency testing program also with its home office in Vancouver, and through them with funding partners including Fondation Mérieux and East Africa Community and the Bernhard Nocht Institute for Tropical Medicine we restructured the training program and added in elements of for data gathering and assessment.

To date we have traveled to and trained personnel in Ethiopia, Senegal, Guinea, Tanzania and Kenya, and so far have been met with a lot of energy and enthusiasm (see pictures attached). I see this as major a contribution for quality improvement in these countries and a step forward towards improving the information on antimicrobial resistance in developing countries.

I have also been working on some projects with the American Society for Quality (ASQ), Standards Council of Canada (SCC) Accreditation Advisory Panel and the European Quality Assurance Committee for Laboratory Quality Management (EQALM) Working Group on Microbiology which allow me to still be and active part of laboratory improvement for the next few years. I will also continue on a teaching capacity in our Certificate Program in Laboratory Quality Management.

Michael A Noble and Family: from Left to Right: Elizabeth, Shira, Steven, Michael, Imogene, Lillian, Alicia, Nicole, Joseph, Jason

I am pleased to be able to say I have played a part in creating some new dynamic activities for promoting Laboratory Quality within our department. In addition having played a part in creating the Donald B Rix Professorship, my family and I have created an endowment to support several Dr. Michael A Noble and Family Awards in Laboratory Quality (the “Noble Prizes”) to recognize achievements of students who focus within their projects and studies on aspects of Quality and Improvement for years to come. There will be more on this initiative soon.

So I have decided to step back, but perhaps not yet ready to retire from retiring. There are a few things that will keep me involved, at least for the next while.