192 Chapter 5 Table 5.3 Examples of improvisational elements Improvisational element Examples and quotations Team skills Expertise This was evident for regulatory respondents whose expertise lay in knowing protocols and regulations, for such conversations as changing procedural norms within the organization, which was not immediately accepted or understood by everyone: “So let’s say ‘normal’ is that a plasmapheresis donor donates about five times a year—and I ask them now to give their plasma as much as possible, as soon as possible, with as short as possible time intervals because we didn’t know anything about titres and how long a titre would be available. These discussions were not always understood by everybody [and caused disagreements]. so we had to ask our [regulatory experts] “What do you think of it?’ ‘Ok, let’s go for it.’ ‘Ok, then we are going to do it’” (Respondent 7). The regulatory respondents agreed not to follow the old change control procedure but modify it accordingly to expedite processes: “we had to go around the system because the system is too slow.” Hence, there was a new, flexible change control mechanism in place. “We learned at Quality Assurance that it is possible to have shortcuts on your change control system. It is possible to have shortcuts on your document management system” (Respondent 8). They outlined that “normally,” before any change occurred in the usual collection procedure, a plan would first need to be detailed, assessed, and approved in the change control management system and the accompanying SOP would need to be revised and approved in the document management system; both were tedious and lengthy processes. In contrast, during the pandemic, the change in plans were verbally discussed, a risk assessment was done, and when consensus was reached, then the SOPs were written and/ or revised, and approved. In this way, changes could be made rapidly in certain procedures so that CCP could be collected quickly. Teamwork quality Respondents shared how they learned to rely on one another to accomplish tasks well: “Because of all the efforts of everybody in this project, and they all see the need of getting it done, a lot of overtime, we did it. And that is something we must be proud of” (Respondent 3). Additionally, there was high awareness of maintaining quality, which doubly benefitted in contributing towards successful “teamwork quality” and product quality: “People were working together in small groups, where I was afraid to lose some of the control, because I wasn’t part of every small group. But when you realize at the end of the day, literally—it all comes together. Everyone tells me what they did. They know quality very well. And I don’t have to tell them that they have to write an SOP because they know. And for me, that was good to know, that the sense of quality is high in the blood bank. It isn’t just relying on me or the QA department” (Respondent 8).
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