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4 Ways to Make the Best Use of Medical Device Remote Audits

Posted by on June 19, 2014

This blog identifies how to use medical device remote audits effectively, save time and resources, and when you should not conduct audits remotely.remote audits blog 4 Ways to Make the Best Use of Medical Device Remote AuditsMost audits ISO 13485 are performed onsite at the location where the processes are being performed, and are the most effective approach to internal and supplier audits. But conducting an audit from your desk makes more efficient use of your time as an auditor. A large percentage of audits are conducted from conference rooms where the auditor spends an excessive amount of time reviewing documents and records, or waiting for documents and records to be delivered. 

In 2006, the first edition of the ISO 17021 standard for certification of quality systems by certification bodies was released. ISO 17021 requires that initial certification audits be conducted in two stages. Stage 1 has several requirements, but the first element of Stage 1 is reviewing quality system documentation. In most cases, Stage 1 and Stage 2 audits are conducted onsite. Still, if the auditee is located in a remote location (such as New Zealand), Stage 1 audits will sometimes be conducted via conference call. 

Prior to ISO 17021, a review of quality system documentation was the only task performed before the initial certification audit, and the documentation review was typically conducted remotely as a “desktop” audit. Desktop audits have been used for decades as a way of auditing quality system documentation without traveling. However, desktop audits can be much more than a review of quality system documentation. You can interview auditees on the phone, review records, even ask auditees to demonstrate activities in real-time using a web camera.

Documentation can also consist of much more than text. Raw data, statistical analysis, and photos can be used to communicate additional information. The more multimedia content provided to auditors remotely, the closer a remote audit becomes to auditing on site. The same requirements as certification bodies do not bound internal auditors and supplier auditors, and audits may be conducted onsite or remotely. The most recent version of ISO 19011 (2011), includes a comparison table for onsite and remote auditing in Annex B.

Medical Device Remote Supplier Audits

The use of remote audits to qualify suppliers is not recommended for four reasons:

  1. onsite visits facilitate the building of supplier-customer relationships
  2. touring facilities and watching a demonstration of processes improves understanding of a supplier’s processes better than reading documents and records can
  3. Cleanliness and capabilities of suppliers are best evaluated onsite, where camera angles can be used to crop out important details
  4. sometimes suppliers misrepresent their capabilities by showing photographs on their website of other companies.

After you have qualified a supplier, however, you may not need to audit them onsite regularly. If a supplier’s performance is good and risks associated with nonconforming components supplied are minimal, then you have a justification for conducting a remote audit. However, if a supplier’s performance is poor, you may want to use a remote supplier audit as a precursor to an onsite supplier audit to investigate the reasons for nonconforming components (i.e., a “for cause” audit). Regardless of the situation, the amount of time spent in your supplier’s conference room should always be by reviewing documents and records remotely. This will reduce the amount of time required at each supplier, and enables you to audit two suppliers during the same trip.

Medical Device Remote Internal Audits

It might not occur to you that there would be any need for remote internal audits. However, not all internal audits are performed by a person working at your location. Larger companies have multiple sites, and many of the internal audits are performed by auditors from corporate headquarters and other locations. In the case of internal audits performed by auditors from other locations, travel time can be minimized by performing part or all of the internal audits remotely. This approach can also work for consultants hired to conduct internal audits. There is no need to spend money on the cost of travel for a consultant if the consultant is only going to be auditing documents and records. The following are great examples of processes that can be audited remotely:

  1. CAPA
  2. Management Review
  3. Internal Auditing
  4. Supplier Controls
  5. Complaint Handling
  6. Adverse Event Reporting

Medical Device Remote Re-audits

21 CFR 820.22 indicates that re-audits may be required where corrective actions have been taken to verify the effectiveness of the actions taken: “Corrective action(s), including a re-audit of deficient matters, shall be taken when necessary.” However, if nonconformities identified during an audit are categorized as “high-risk,” it may be essential to conduct a verification of corrective action effectiveness as soon as possible.

Sometimes, effectiveness can be determined by reviewing quantitative metrics. Still, if a re-audit is needed, then a remote re-audit may allow the auditor to verify the effectiveness of corrective actions without the necessity of being onsite. If verification of corrective action effectiveness can be performed by reviewing documents and records, a remote re-audit is appropriate. Other corrective actions, especially those involving production and process controls, typically require onsite verification.

Remote Audit Team Members

Most medical device companies have a limited number of qualified auditors, and auditing is almost always a secondary job duty. However, audits often require specific technical knowledge that only one or two auditors may possess. Therefore, it may be extremely difficult to schedule a team audit when all the required auditors and auditees are available. There is another option to postponing your audit. You might consider having some of your auditing team members audit remotely from their desks, while the rest of the team conducts an onsite audit. For example, most lead auditors can conduct a process audit of incoming inspection, storage, and shipping. However, auditing surface mount assembly lines for the fabrication of printed circuit boards requires more technical knowledge of this type of process. Technical expertise is also needed to audit sterilization or CNC machining.

By working together, onsite audit team members can take directions from a technical subject matter expert working remotely and gather information needed to audit any process properly. This approach minimizes time requirements for subject matter experts, and remote audits by team members reduce the cost of travel.

If you are interested in learning more about Turtle Diagrams and the process approach to auditing, please register for our webinar on the process approach to auditing. If you are interested in learning more about how you can use remote audits to save time and money, please contact us. We can help you identify immediate opportunities.

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5 Criteria for a Certified Internal Auditor Program

Posted by on May 19, 2014

5 criteria 5 Criteria for a Certified Internal Auditor ProgramThis article identifies five criteria for a certified internal auditor program of medical device lead auditors for ISO 13485 quality systems auditing and supplier auditing.  Five criteria are important to a certified internal auditor program:

  1. formal training by a qualified trainer
  2. an exam to demonstrate the effectiveness of training
  3. practical experience
  4. observation of actual audits by an experienced lead auditor
  5. documentation

Internal auditors do not need a certificate from a third-party (i.e., someone other than your company or your customers), and training programs do not need to be accredited. Your company can save money and develop an in-house certification program. The only reason why third-party certification and accreditation are needed is 1) if your internal auditor procedure requires it, or 2) if you are training to become a third-party auditor working for a certification body or registrar. Therefore, I don’t recommend writing a procedure that requires a certificate from a third party or an accredited program. Write your internal auditor training requirements to allow flexibility, but ensure you include each of the five elements listed above.

1. Formal training by a qualified trainer

Formal training is planned and has a documented curriculum. The curriculum can consist of one long course over several days, or you can limit the duration of each class to an hour over several months, and you can develop a schedule to fit individual needs. Training should be customized to a certain extent for each internal auditor, but most programs have at least one primary lead auditor course that everyone must complete. A qualified trainer must also deliver formal training.

2. An exam to demonstrate the effectiveness of training

I have written about the use of exams to document training effectiveness. You can use a combination of multiple-choice questions, fill-in-the-blank, short answer, and essay questions for an exam. However, for demonstrating the effectiveness of auditor training, there is one method of evaluation that is superior to all others–writing nonconformities. If you provide a hypothetical scenario to an auditor, the auditor should be able to write a complete nonconformity. This exercise tests the auditor’s ability to identify the applicable regulatory requirements, assess conformity, grade nonconformities, and select the appropriate wording of the nonconformity and associated objective evidence. The only downsides to writing nonconformities are: 1) they are harder for instructors to grade, and 2) the grading is subjective.

3. Practical experience

The most common way to document the previous experience of internal auditors is to include a copy of the person’s resume in their training record. However, I recommend using a tracking log for all audits to identify which auditors conducted which audit. Ideally, you want to use an electronic database that allows you to search the database using the name of the auditor as a search field. Your database should also indicate which role the auditor was fulfilling: 1) lead auditor, 2) team member, 3) trainee, or 4) observer. Sometimes, the person may have more than one role (e.g., team member and trainee or lead auditor and observer).

4. Observation of actual audits by an experienced lead auditor

It doesn’t matter if training is remote and recorded or live and in-person, but remote and recorded training needs to balanced with an observation of actual audits by an experienced medical device quality system auditor. “Observation” needs to be defined, but I recommend using a controlled form to document observations. Attaching a completed observation form to a copy of auditing notes and a copy of the audit report creates a complete record to demonstrate observation of each audit by a trainee. Just don’t make your controlled form overly burdensome. A single page is fine–as long as it consists of more than yes/no checkboxes. “Experienced” also needs to be defined, but I recommend the following combination of qualitative and quantitative experience. First, an experienced lead auditor must have documented formal training, but formal training does not need to be third-party training. Second, an experienced lead auditor should have completed at least 100 audits. One hundred is an arbitrary number, but that number represents more than 1,000 hours of audit preparation, auditing, and report writing. Anything less than 1,000 hours is inadequate to be qualified to begin training others.

5. Documentation

Documentation must include all of the above elements. You need to document the training plan for each internal auditor, and it must meet minimum training requirements–which should be documented in your internal auditing procedure. Your documentation should include minimum criteria for qualification of a trainer–often a resume, and adding the person to your approved supplier list is sufficient. You should document the results of any formal quizzes and exams for training effectiveness. Auditing experience for each person should be documented. Specifically, you should have a form listing a description of the scope and dates for each audit during the certification process. Observations of auditors need to be documented, and any corrections or recommendations for improvement should include documented follow-up. If an auditor already has extensive experience before joining your company, your procedures should allow for a written justification, instead of repeating the training. If your company uses a software tool to manage training, I recommend creating a separate training group for internal auditors, rather than incorporating internal auditing into another job description and/or training curriculum.

What Really Matters

What matters is whether your internal auditor training is effective and internal auditors are competent. Certificates make pretty training records to post on the wall of your cubicle. Competent internal auditors identify quality issues before you receive an FDA 483, or a nonconformity from your certification body. Competent auditors also add value by identifying ways to make processes more efficient and opportunities to save money. If you are looking for a qualified trainer to provide formal training, in a public venue or in-house, please visit the following webpage: http://bit.ly/Lead-Auditor-Course.

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An Auditor’s Best Practices in Issuing a Major Nonconformity

Posted by on March 18, 2013

%name An Auditors Best Practices in Issuing a Major Nonconformity

From the opening meeting through the audit and closing meeting, the author describes an auditor’s best practices in issuing a major nonconformity.

As an auditor, one of the most important (and difficult) things to learn is how to issue a nonconformity—especially a major. This is usually done at the closing meeting of an audit, but the closing meeting is not where the process of issuing the nonconformity begins. Issuing a nonconformity starts in the opening meeting.

ISO 19011:2011 is the official guidance document for auditors of Quality Management Systems, and ISO 13485 is the quality system standard for medical device manufacturers. Section 6.4.2 of this Standard explains best practices for an opening meeting. The last five items in this section are critical to preparing the client for potential nonconformities:

  1. Method of reporting audit findings, including grading, if any
  2. Conditions under which the audit may be terminated
  3. Time and place of the closing meeting
  4. How to deal with possible findings during the audit
  5. System for feedback from the auditee on findings or conclusions of the audit
  6. Process for complaints and appeals
Methods of Reporting and Grading Nonconformities

The auditor should be crystal clear in their description of minor and major nonconformities or any other grading that will be used. The auditor should also make it clear that they are looking for conformity rather than nonconformity. This is an audit—not an inspection. Typically, a minor nonconformity is described as “a single lapse in the fulfillment of a requirement,” while a major nonconformity is described as one of the following: 1) “a total absence in the fulfillment of a requirement,” 2) “repetition of a previous nonconformity,” 3) “failure to address a previously identified minor nonconformity,” or 4) “shipment of non-conforming product.” When the auditor is in doubt, then the finding is minor, and never a major. For a major nonconformity to be issued, there can be no doubt.

Conditions for Termination

The option to terminate an audit is typically reserved for a certification audit where a major nonconformity is identified, and there is no point in continuing. Termination is highly discouraged, because it is better to know about all minor and major nonconformities right away, instead of waiting until the certification audit is rescheduled. The certification body will charge you for their time anyway.

Another reason for termination is when an auditor is unreasonable or inappropriate. This is rare, but it happens. If the audit is terminated, you should communicate this to upper management at the certification body and the company—regardless of which side of the table you sit. For FDA inspections, this is not an option. For audits performed by Notified Bodies, there is the possibility of suspension of a certificate in response to audit termination. Therefore, I always recommend appealing after the fact, instead of termination. Appealing also works for FDA inspections.

How to Deal with Findings

All guides and auditees should be made aware of possible findings at the time an issue is discovered. This is important so that an auditee has the opportunity to clarify the evidence being presented. Often, nonconformities are the result of miscommunication between the auditor and the auditee. This frequently happens when the auditor has a poor understanding of the process being audited. It is a tremendous waste of time for both sides when this occurs. If there is an actual nonconformity, it is also important to gather as much objective evidence as possible for the auditor to write a thorough finding and for the auditee to prepare an appropriate corrective action plan in response to the discovery.

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Feedback from the Auditee

As an auditor, I always encourage auditees to provide honest feedback to me directly and to management, so that I could continue to improve. If you are giving feedback about an internal auditor or a supplier auditor, you should always give feedback directly before going to the person’s superior. You are both likely to work together in the future, and you should give the person every opportunity to hear the feedback first-hand.

When providing feedback from a third-party certification audit, you should know that there will be no negative repercussions against your company if you complain directly to the certification body. At most, the certification body will assign a new auditor for future audits and investigate the need for taking action against the auditor. In all likelihood, any action taken will be “retraining.” I never fired somebody for a single incident—unless they broke the law or did something unsafe. The key to providing feedback, however, is to be objective. Give specific examples in your complaint, and avoid personal feelings and opinions.

Complaints and Appeals

As the auditee, you should ask for the contact information of the certification body during the opening meeting. Ask with a smile—just in case you disagree, and so you can provide feedback (which might be positive). As the auditor, you should always make contact information for the certification body available. If you are conducting a supplier audit or an internal audit, you probably know the auditor’s boss, and there is perhaps no formal complaint or appeals process. In the case of a supplier audit, the customer is always right—even when they are wrong.

During the Audit

During the audit, you should always make the guide(s) and process owner(s) aware of any potential nonconformities as you find them. This is their opportunity to clarify the objective evidence for you and to explain why there is not a nonconformity. Often, at this point in the audit, I will refer to the Standard. I will identify the specific requirement(s) and show the process owner. I will say, “This is what I am trying to verify. Do you have anything that would help address this requirement?” If the process owner is unsure of how to meet the requirement, often, I will provide an example of how this requirement is addressed in other areas or at other companies.

If the audit is a multi-day audit, I will review the potential nonconformities at the end of the day and allow the auditee to provide additional objective evidence in the morning. If it is the last day of the audit, or it is a single-day audit, I will give auditees until the closing meeting to provide the objective evidence. Often, I will use this opportunity to explain what would be considered a minor nonconformity and what would be a major nonconformity. Usually, I can say, “This is not a major nonconformity because…”

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Closing Meeting

The closing meeting should be conducted as scheduled, and the time/location should be communicated to upper management in the audit agenda and during the opening meeting. Top management won’t be happy about nonconformities, but failure to communicate when the closing meeting will be conducted will irritate them further.

At the closing meeting, the auditee should never be surprised. If an issue remains unfulfilled at the closing meeting, the auditee should be expecting a minor nonconformity—unless the issue warrants a major nonconformity. Since a minor nonconformity is described as “a single lapse in the fulfillment of a requirement,” it is difficult for an auditee to argue that an issue does not warrant a minor nonconformity. Typically, the argument is that you are not consistent with other auditors. The most common response to that issue is, “Audits are just a sample, and previous auditors may not have seen the same objective evidence.” The more likely scenario, however, is that the previous auditor interprets requirements, instead of reviewing requirements with the client, and ensuring both parties agree before a finding is issued.

If a finding is major, the auditee should have very few questions. Also, I often find the reason for a major nonconformity is a lack of management commitment to address the root cause of a problem. Issuing a major nonconformity is sometimes necessary to get management’s attention.

Regardless of the grading, all audit findings will require a corrective action plan—even an FDA warning letter requires a CAPA plan. Therefore, a major nonconformity is not a disaster. You just need to create a more urgent plan for action.

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The Audit Program Manager: 4 Areas of Auditor Competency

Posted by on December 24, 2012

rookie The Audit Program Manager: 4 Areas of Auditor Competency

Passing a webinar on auditing does not make you competent.

This blog reviews an audit program manager’s four areas of auditor competency; experience, skills, training, and education.

Does your company ask incoming inspectors to update CAD drawings when there is a design change? Of course not. Your company has engineers that are trained to use SolidWorks, and it takes a new engineer awhile to become proficient with the software. Auditing is a skill that you learn—just like SolidWorks.

I’ve never met a manager that wondered where the value was in having an engineer update a drawing, but many managers view internal and supplier audits as a necessary evil. Instead of asking the expert how few audit days you can get away with, ask the expert: “What is the purpose of auditing?”

The purpose of internal auditing is to confirm that the management system is effective and identify opportunities for improvement. The purpose of supplier auditing is to verify that a supplier is capable of meeting your needs and identify opportunities for improvement. Therefore, if an auditor has no nonconformities and no opportunities for improvement were identified—what a waste of time!

To receive value from auditing, you need auditors that are competent. In clause 6.2.1 of the ISO 13485 Standard, it states, “Personnel performing work affecting product quality shall be competent based on appropriate education, training, skills, and experience.” As the audit program manager, ensure you recruit people that demonstrate auditing competency.

Education

First, educational background is important for auditors. You cannot expect someone who has never taken a microbiology course in their life to be an effective auditor of sterilization validation. Likewise, someone that has never taken a course in electricity and magnetism will not be effective as an auditor for active implantable devices. Therefore, determine what types of processes the auditor will be auditing. Then ensure that the person you hire to be an auditor has the necessary education to understand the processes they will be auditing.

Training

Second, an auditor needs to be trained before they can audit. The auditor needs training in three different aspects: 1) the process they will be auditing, 2) the standard that is the basis for assessing conformity, and 3) auditing techniques. If you are going to be auditing Printed Circuit Board (PCB) manufacturers with Surface-Mount Technology (SMT), then you need to learn about the types of components used to make PCBs, and how these components are soldered to a raw board. I know first-hand that anyone can learn how SMT works, but it took me a few months of studying.

If your company is only selling medical devices in the United States, then you will need to learn 21 CFR 820 (i.e., – the QSR). However, if your company also sells devices in Europe or Canada, you will need to learn ISO 13485, the Medical Device Directive (MDD) (93/42/EEC as modified by 2007/47/EC), and the Canadian Medical Device Regulations (CMDR). I learned about ISO 13485 in a four-and-a-half day lead auditor course in Florida,  MDD in a three-day CE Marking Course in Virginia, and the CMDR in a two-day course taught by Health Canada in Ontario. A 50-minute webinar on each regulation is not sufficient for auditing.

Finally, you need training in the techniques of auditing. A two-day course is typically needed. I took a 50-minute webinar and passed a quiz before conducting my first internal audit, but I had not developed my skills at that point. 

Skills

Third, an auditor needs communication, organizational, and analytical skills to be useful as an auditor. Communications skills must include the ability to read and write exceptionally well, and the auditor needs to be able to verbally communicate with auditees during meetings and interviews. The most difficult challenge for auditors is covering all items on their agenda in the time available. The auditor rarely has more time than the need to audit any topic, and audit team leaders must be able to manage their own time, as well as simultaneously managing the time of several other auditors. 

Experience

Last, but indeed not the least important aspect of auditor competency, is experience. This is why third-party auditors are required to act as team members under the guidance of a more experienced auditor before they are allowed to perform audits on their own. This is required, regardless of how many internal or supplier audits, the person may have conducted in the past. More experienced auditors are also required to observe new auditors and recommend modifications in their technique. Once a new auditor has completed a sufficient number of audits as a team member, the auditor is then allowed to practice leading audits while being observed. After six to nine months, a new auditor is finally ready to be a lead auditor on their own. An internal auditor does not need the same degree of experience as a third-party auditor, but being shadowed two-three times is not sufficient experience for an auditor (first or second-party). For more information about this topic, please read my blog posting on auditor shadowing.

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Internal Audit Training for New Hires

Posted by on December 24, 2012

 

welcome aboard Internal Audit Training for New Hires

The author discusses a few proven internal audit training strategies (i.e., shadowing, auditing process owners) for new hires.

Once you have identified someone that you want to “hire” as an internal auditor, your next step should be to develop an “Onboarding“ plan for them with their boss. If you are hiring someone that will be a dedicated auditor, please ignore my quotation marks above. In most companies, however, the internal auditors are volunteers that report to another hiring manager. Therefore, as the audit program manager, you need to get a firm commitment from the auditor’s boss with regard to the time required to train the new auditor and to perform audits on an ongoing basis. 

Winning Over the Boss

In my previous posting, I said that “The biggest reason why you want to be an auditor is that it will make you more valuable to the company.” The auditor’s boss may or may not agree with this statement, but the boss knows that the salary is coming out of their budget either way. Therefore, talk with the auditor’s boss and determine what the auditor’s strengths and weaknesses are. Find out which skills the boss would like to see the auditor develop. By doing this, the two of you can develop a plan for making the auditor more valuable to their boss AND the company. 

Making Re-Introductions

Ideally, auditors are extraverted and have worked at the company long enough to know the processes and process owners that they will be assigned to audit—especially if they will be auditing upstream and downstream from their process area. In the past, the auditor may have been a customer or a supplier, but now the relationship with a process owner will change. Auditors are required to interview process owners, and this involves asking tough questions that might not be appropriate in the auditor’s regular job duties. Therefore, as the audit program manager, you should re-introduce the auditor to the process owner in their new capacity as an auditor. During this re-introduction, it is important to make three points:

  1. The auditor is going to be trained first (on auditing and ISO 13485)
  2. You will be shadowing the auditor during the audit, and
  3. The auditor’s job is to help the process owner identify opportunities for improvement

By making the first point, you are reminding the process owner of the scheduled audit—well in advance. You are also informing the process owner that this auditor will have new skills, and the process owner should have some tolerance for mistakes that new employees make. You might also mention that you would like to get the process owner’s feedback after the audit, so the auditor knows which areas they need to improve upon to become better auditors. The second point should put the process owner at ease—assuming the process owner has a good relationship with you as the audit program manager. It is important to be descriptive when “shadowing” is mentioned. Both the process owner and the auditor may not understand the process or the purpose of shadowing. The following blog posting might help with this: “How do you shadow an auditor? Did you learn anything?”

The third point is the most critical step in onboarding a new auditor. For an auditor to be successful, they must ADD VALUE! As an auditor, you cannot pretend to add value. The process owner should know their process, and they probably know which areas are weakest. The audit program manager should encourage the process owner to list some specific areas in which they are having problems. Ideally, the process owner would be informed of this need before the re-introduction. Then the process owner can be better prepared for the meeting, and hopefully, they will have a few target areas already identified. Targets with associated metrics are the best choice for a new auditor because these targets reinforce the process approach to auditing. 

Next Steps for Internal Audit Training

Once your new auditor has been re-introduced to the process owners, they will be auditing, and you need to begin the training process. As with any new employee, it is important to document training requirements and to assess the auditor’s qualifications against the requirements of an auditor. Every new auditor will need some training, but the training should be tailored specifically to the needs of the auditor. The training plan for a new auditor should include the following:

  1. A reading list of company procedures specific to auditing and external standards that are relevant
  2. Scheduled dates for the auditor to shadow another experienced auditor
  3. Scheduled dates for an experienced auditor to shadow the auditor during the first two process audits (upstream and downstream)
  4. Goals and objectives for the internal audit program; and
  5. Any training goals that the auditor’s boss has identified for the auditor

 

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Effective Recruiting for the Auditor Position

Posted by on December 22, 2012

help wanted Effective Recruiting for the Auditor Position

Stop begging people to help you audit. Learn how to recruit auditors more effectively.

This blog shares thoughts related to effectively recruiting for the auditor position. One suggestion may surprise you.

Nearly 100% of the people I train as auditors were not hired specifically to be auditors. Instead, auditing is something extra that they were asked to do, in addition to their regular job. This situation creates three problems for the audit program manager:

  1. You have difficulty getting enough people to perform the audits.
  2. Most auditors will come from your department, so who is going to audit you?
  3. Auditors have little or no motivation to develop their auditing skills.

Stop begging for “volunteers” from other departments and start recruiting.

When I am recruiting someone to audit, I always get asked two questions:

  1. Who/What will I be auditing?
  2. What will I have to do?

You need to motivate people to become auditors because it requires extra work. The answer to #2 should be specific. I recommend creating a “sell sheet” that explains the process of performing an audit. I also like to develop educational sell sheets. Therefore, I recommend adopting the flow chart in ISO 19011:2011 (Figure 2 on page 15). I would add time estimates for each step of the process (6.2 – 6.7). This will serve as a training tool for future auditors and will eliminate the fear of an unknown time commitment for your potential recruit.

In order to answer #1, I recommend you assign the recruit processes that are upstream and downstream. I have recommended this concept in previous postings, but essentially you are assigning the person to audits of internal suppliers and internal customers. By doing this, utilizing the process approach will be more natural to the auditor and they will have a vested interest in doing a thorough audit. This also creates a situation where the auditor is typically assigned to at least two process audits per year.

The next question is one that your potential recruit will never ask, but they are always thinking…

Why should I become an auditor?

The biggest reason why you want to be an auditor is that it will make you more valuable to the company.

Auditors are required to interview department managers and ask tough questions. This gives the auditor a better understanding of the organization as a whole, and it gives them insight into how other managers work. This insight is pure gold.

If you want to be effective and get promoted, you need to demonstrate value to your boss and top management. If you don’t understand what other departments need, how can you help them? No manager will promote a selfish, power-hungry hog. They promote team players that make others better. Auditing gives you the insight necessary to understand how you can do that.

Auditing other departments will also give you insider information as to where new job openings will be. Sometimes you can’t wait for your boss to get promoted. In that case, you might want to know more about other departments in your company.

Each corporate culture is different, but the audit program manager needs to “sell” the recruit on volunteering to be an auditor.

Where to find recruits

Due to the cross-functional nature of auditing, I have found that my own personal experience working in multiple departments was invaluable. I have a better understanding of how a department functions than other auditors because I have worked in that department at another company. Operations, engineering and research experience are extremely valuable for auditing, but I believe the experience that transfers best to auditing is any position where you are addressing customer complaints and returns—such as technical support or service.

If your company is large enough to hire full-time auditors, I recommend searching for potential auditors at your suppliers and their competitors. These people will bring unique knowledge that is critical to a successful supplier selection process, and these individuals will increase the diversity in your company—instead of duplicating knowledge and expertise.

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How to Finish your Audit Schedule by December 31st

Posted by on November 28, 2012

This blog provides viable options to consider related to successfully completing your audit schedule by year’s end.

Let’s say that there are 34 days until the end of 2012. You have four supplier audits and three internal audits to complete. Of course, all but two of these ISO 13485 audits are overdue. What should you do?

Options that might be readily available to you include:

  1. Get some help
  2. Perform remote audits
  3. Reschedule some of the audits for next year

There are some great cartoons and jokes about doing more with less, but if you intend to complete seven audits before the end of the year, you might need some help. There really isn’t any time left to train someone, so that they are capable of conducting an effective audit by themselves. I expect to prepare a new auditor to take at least six months before I believe they are ready to work solo. Even if you are less demanding than I am, you still would need time for classroom training and shadowing a couple of audits. Therefore, the best I believe you could hope for is one or two solo audits of the seven you need to complete.

Realistically, your only source of help would be auditors that are already trained and consultants. The last month of the year is historically hectic for everyone–especially quality assurance auditors. Therefore, consultants will not be cheap, and you should commit to any qualified consultants that are available without too much delay (then again, maybe they are available because they are not very good). If you have any in-house auditors that are already trained, do everything you can to get some of their time in the next few weeks.

Remote Audits

Option two is to perform remote audits. This is a viable option for you to justify for a supplier with an impressive quality track record, or suppliers in other countries. However, a remote audit is not the same as asking a supplier to complete a survey. ISO 19011:2011 provides some guidance specific to remote auditing in table B.1 of Annex B.

For a remote audit, you should still sample just as many records—if not more. You should conduct interviews by phone, Skype, or some similar technology. You should analyze any available data to help identify which processes appear to be effective and which processes need to improve. If you are performing a remote audit for the first time, I recommend focusing on the same processes that you would normally audit in a conference room, rather than processes that you would typically audit where they occur—such as production controls. Regardless of which process you check, you should always request data.

Option three is to reschedule some audits for January 2013. I have suggested this so many times to clients, but very few follow this advice. If your company is late in conducting some audits, the important thing to do is to document this, reschedule the audits, and take corrective action(s) to prevent it from recurrence. If you wait until January, you will have additional time to train an auditor, as well. Finally, consultants historically have more time available in January than December.

In parallel with your efforts to catch-up on your schedule, I also recommend the following:

Create a quality objective that measures the “on-time delivery” of audits and audit reports. This is an effective metric for managing an audit program.

Investigate the reasons for audits being overdue. If the occurrence was preventable, then I recommend initiating a CAPA. This will have two effects. First, your third-party auditors will see that you have identified the problem yourself and taken appropriate corrective action(s). If you also discuss this during a Management Review, this information can be used effectively to change the grading of an audit finding to a “minor,” or to potentially eliminate the finding altogether. Second, it will ensure that this doesn’t occur again.

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Auditor shadowing as an effective auditor training technique

Posted by on November 25, 2012

This article reviews auditor shadowing as an effective auditor training technique, but we also identify five common auditor shadowing mistakes.

auditor with clip board 203x300 Auditor shadowing as an effective auditor training technique

If you are shadowing, you are taking notes, so you can discuss your observations with the person you are shadowing later.

How do you evaluate auditor competency?

Somewhere in your procedure for “Quality Audits,” I’ll bet there is a section on auditor competency. Most companies require that the auditor has completed either a course for an internal auditor or a lead auditor course. If the course had an exam, then you might even have evidence for training effectiveness. Demonstrating competency is much harder. One way is to review internal audit reports, but writing reports are just part of what an auditor does. How can you evaluate an auditor’s ability to interview people, take notes, follow audit trails, and manage their time? The most common solution is to require that the auditor “shadow” a more experienced auditor several times, and then the trainee will be “shadowed” by the trainer. 

Auditor shadowing in 1st party audits

ISO 19011:2011 defines first-party audits as internal audits. When first-party auditors are being shadowed by a trainer or vice versa, there are many opportunities for training. The key to the successful training of auditors is to recognize teachable moments.

When the trainer is auditing, the trainer should look for opportunities to ask the trainee, “What should I do now?” or “What information do I need to record?” In these situations, the trainer is asking the trainee what they should do BEFORE they do it. If the trainee is unsure, the trainer should explain what, why, and how at that moment with real examples.

When the trainer is shadowing, the trainer should watch and wait for a missed opportunity to gather important information. In these situations, the trainer must resist guiding the trainee until after the trainee appears to be done. When it happens, sometimes the best tool is simply asking, “Are you sure you got all the information you came for?”

Here are five (5) mistakes that I had observed trainers make when they were shadowing:

1. Splitting up, instead of staying together, is one of the more common mistakes I have observed. This happens when people are more interested in completing an audit, rather than taking every advantage of training opportunities. The trainee may be capable of auditing on their own, but this is unfair to the trainee because they need feedback on their auditing technique. This is also unfair to the auditee because it is challenging to support multiple auditors simultaneously. When it is unplanned, there may not be trainers available for both auditors. If an audit is running behind schedule, this is the perfect time to teach a trainee how to recover sometime in their schedule. Time management is, after all, one of the hardest skills for auditors to master.

2. Staying in the conference room, instead of going to where the work is done, is a common criticism of auditors. If the information you need to audit can be found in a conference room, then you could have completed the audit remotely. This type of audit teaches new auditors very little, other than how to take notes. These are necessary skills that auditors should master in a classroom before shadowing.

3. Choosing an administrative process is a mistake because administrative processes limit the number of aspects of the process approach that can be practiced by an auditor-in-training. Administrative processes rarely have equipment that requires validation or calibration, and both the process inputs and outputs consist only of paperwork, forms, or computer records. With raw materials and finished goods to process, the job of the auditor is more challenging, because there is more to be aware of.

4. Not providing honest feedback is a huge mistake. Auditors need to be thick-skinned, or they don’t belong in a role where they are going to criticize others. Before you begin telling other people how to improve, you first need to self-reflect and identify your own strengths and weaknesses. Understanding your perspective, strengths, weaknesses, and prejudices is critical to being an effective assessor. As a trainer, it is your job to help new auditors to self-reflect and accurately rate their performance against objective standards.

5. “Silent Shadowing” has no value at all. By this, I mean shadowing another auditor without asking questions. If you are a trainee, you should be mentally pretending you are doing the audit. Whenever the trainer does something different from the way you would do things, you should make a note so you can ask, “Why did you do that?” If you are the trainer, you should also be mentally pretending you are doing the audit. It is not enough to be present. Your job is to identify opportunities for the trainee to improve. The better the trainee, the more challenging it becomes to identify areas for improvement.  This is why training other auditors have helped me improve my auditing skills.

Auditor shadowing in second-party audits

supply chain weakest link Auditor shadowing as an effective auditor training technique

If you are developing a new supplier quality engineer that is responsible for performing supplier audits, it is recommended to observe the auditor during some actual supplier audits. Supplier audits are defined as second-party audits in the ISO 19011 Standard. The purpose of these audits is not to verify conformity to all the aspects of ISO 13485. Instead, the primary purpose of these audits is to verify that the supplier has adequate controls in place to consistently manufacture conforming products for your company. Therefore, processes such as Management Review (Clause 5.6) and Internal Auditing (Clause 8.2.2) are not typically sampled during a second-party audit.

The two most valuable processes for a second-party auditor to sample are 1) incoming inspection, and 2) production controls. Using the process approach to auditing, the second-party auditor will have an opportunity to verify that the supplier has adequate controls for documents and records for both of these processes. Training records for personnel performing these activities can be sampled. The adequacy of raw material storage can be evaluated by following the flow of accepted raw materials, leaving the incoming inspection area. Calibration records can be sampled by gathering equipment numbers from calibrated equipment in use by both processes. Even process validation procedures can be assessed by comparing the actual process parameters being used in manufacturing with the documented process parameters in the most recent validation or re-validation reports.

My recommendation is to have the trainee shadow the trainer during the process audit of the incoming inspection process, and for the trainer to shadow the trainee during the process audit of production processes. In between the two process audits, the trainee should be asking questions to help them fully understand the process approach to auditing. Supplier auditors should also be coached on techniques for overcoming resistance to observing processes that may involve trade secrets, or where competitor products may also be present. During the audit of production processes, the trainer may periodically prompt the trainee to gather the information that will be needed for following audit trails to calibration records, document control, or for comparison with the validated process parameters. The “teachable moment” is immediately after the trainee missed an opportunity, but while the trainee is still close enough to go back and capture the missing details.

Auditor shadowing in third-party audits

qsit inspection Auditor shadowing as an effective auditor training technique

Use your FDA inspections and ISO certification audits as an opportunity to shadow experienced auditors and to learn what they are looking for.

If you are going to shadow a third-party auditor, I recommend two specific people to “shadow” the auditor. First, the process owner should be the guide for whichever process is being audited. This is the person that will be responsible for addressing any nonconformities found in the area, and they should be present during interviews–although they should be coached on when to comment and when to remain quiet and simply observe.  Second, the person that performed an internal audit of the process being audited should be present if at all possible. This person will benefit from seeing how a professional third-party auditor performs a process audit because they will know which things to look for in the future so that auditees in that area are prepared for the next external audit.

For other sources of information related to auditor shadowing, please check out the following links:

1. Internal Auditor Training – Shadowing external auditor? – from Elsmar Cove

2. Developing Supplier Quality Auditor Training Programs – by Seth Mailhot at Nixon Peabody

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Instructor Effectiveness and the Power of a SNICKERS

Posted by on November 13, 2012

The author discusses his personal experience attending a training class, instructor effectiveness, and reasons why he learned so much there.

I guess there are still some instructors out there that need to be reminded that we can all read the regulations on our own. We don’t need to pay $1,000+ per day to have someone read stuff for us. If that’s what you want, my 10-year old son is a fantastic reader. He’ll record anything you want, in any media format, for a much smaller dollar figure. If you want to learn something that is worth at least as much as your investment of time and money, then you need to find an instructor that can teach effectively.

Four Prerequisites for a Great Instructor:

1. The instructor must be an expert

2. The instructor must inspire participation

3. The instructor must provide practical examples for each student

4. The instructor must get everyone’s attention–and keep it

The most important determining factor of training effectiveness, however, occurs after the course is over When you are teaching quality assurance and regulatory affairs, you must develop your ability to inspire and engage students to Olympic medalist proportions. “Blah, blah, blah…” and “Death by PowerPoint” will get you fired. Don’t read your slides, don’t turn your back on the audience (or they’ll attack) and PLEASE don’t ever ask someone to read the definition of nonconformity out loud to the rest of the group. When I teach a class, you demand my best. I’m six-foot, six inches tall, and I have a loud booming voice. My mother has red hair, and she was an opera singer. I’ve got the voice to fill any auditorium and stage presence to match. But if you even start to nod off in class, I may just have to throw a Snickers bar at you.

snickers Instructor Effectiveness and the Power of a SNICKERS

This is an essential tool for any instructor. It functions as a tool to prod sleeping students awake, is small enough to cause minimal injury when thrown, serves as an emergency food supply, and is gluten-free.

If legal counsel recommends against using projectiles to encourage class participation, you might also consider one of my all-time genius ideas. I was scheduled for a two-day course in Ottawa, but the day before, I needed to perform an audit in Pennsylvania. Therefore, my flight was the last flight into Ottawa–arriving at approximately 1 a.m. My flight was delayed for more than an hour, and the person in front of me was trying to smuggle an extra carton of smokes into the country. Just before 4 a.m., my taxi arrived at the Albert at Bay Suite Hotel. The class started at 8 a.m. I made it to class on time, and excessive consumption of several pots of black coffee helped get me to lunch. Then my legs started getting a little shaky. Fortunately, there was a convenience store next door that sold my favorite chocolate–the Dark Aero bar! After four of these monstrous doses of cacao, and another pot of coffee, I could have listened to the lecture on the Canadian Medical Device Regulations all night.

aero bar Instructor Effectiveness and the Power of a SNICKERS

Hershey’s copied them, but the result was a mere shadow of Nestle’s greatness. Canadians know how to make junk food, tell a joke, and play hockey!

Lessons Learned

Despite the physical handicap of sleep deprivation, I still learned a ton from my course in Canada. Here’s why:

1. The instructors were experts. Both instructors were regulatory experts and Canadian. Both instructors taught this course twice a year for multiple years, and one of the instructors actually worked for Health Canada.

2. The instructors were blessed with the perfect audience that was hyper-motivated to pass the course. Everyone in the class worked for a Notified Body that had sponsored them to take the course. In order to stay employed and get a raise, I needed to pass that course. If I failed the exam, I had to absorb the cost to travel back to Ottawa and retake the course in February (BRRRR!).

3. Everyone has different experiences, and therefore not every example makes sense to us. Therefore, instructors need to use practical examples that are actionable. In this course, the instructors brought more than a dozen medical devices to the class. We studied the labeling and intended use of each device. Even students from Japan, Europe, and Australia were familiar with some of the products. This was critical because we all needed to be able to identify incorrect Canadian labeling.

4. The greatest asset of all was the humor of the instructor from Health Canada. He was hilarious. He had everyone laughing at his jokes for the entire course. Most of the jokes were not funny enough for a stand-up routine, but this was a mandatory regulatory course on Canadian regulations. Who would even expect a chuckle? Despite the strengths of these instructors, there is only one reason why I know the Canadian Medical Device Regulations (CMDR), as well as I do. I use them every single week.

Some Examples of How I Used the CMDR:

First, I had to audit 162 days for BSI in 2011. Ninety percent of those 162 days were for companies that required a Canadian Medical Device License. Therefore, I started auditing companies to the Canadian regulations immediately after the course. Second, I was also consulting for companies at the same time I was auditing for BSI. Consulting clients hired me to prepare and submit the Canadian Medical Device License Applications for them. I also had to revise and create new procedures specific to Canadian regulations. I spent another 60+ days in 2011 doing consulting. Finally, I was one of BSI’s instructors that taught the regulatory comparison course, which compared the regulations of the USA, Canada, Europe, Australia, and Japan.

Therefore, at least once a month, I had a classroom of 6-20 people asking me challenging questions about how to interpret and apply regulations from each of these countries to their products. I used every bit of knowledge I learned in that course in Ottawa, and I started using that knowledge immediately after the course. I had peers, superiors, clients, and students challenging my knowledge of these topics every day. This is what makes you a subject matter expert. If you need to learn something about Quality Assurance or Regulatory Affairs, a one-hour webinar, reading a blog, taking a five-day, or shadowing another more experienced person is not enough. In the end, all of the above will get you to the level of barely competent!  If you want to learn, you need a great instructor. Then you need to use everything you learned at every opportunity for several years. Some say, “If you can’t do, teach.” I say, “Bring a SNICKERS bar and throw it at them for faking it.”

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Auditing Design Controls – 7 Step Process

Posted by on June 23, 2012

This blog reviews seven steps for effectively auditing design controls utilizing the ISO 13485 standard and process approach to auditing.

turtle diagram for design controls Auditing Design Controls 7 Step Process

Third-party auditors (i.e., – a Notified Body Auditor) don’t always practice what we preach. I know this may come as a huge shock to everyone, but sometimes we don’t use the process approach. Auditing design controls is a good example of my own failure to follow was it true and pure. Instead, I use NB-MED 2.5.1/rec 5 as a checklist, and I sample Technical Files to identify any weaknesses. The reason I do this is that I want to provide as much value to the auditing client as possible without falling behind in my audit schedule.

Often, I would sample a new Technical File for a new product family that had not been sampled by the Technical Reviewer yet. My reason for doing this is that I could often find elements that are missing from the Technical File before the Technical Reviewer saw the file. This gives the client an opportunity to fix the deficiency before submission and potentially shortens the approval process. Since NB-MED documents are guidance documents, I could not write the client up for a nonconformity, unless they were missing a required element of the M5 version of the MDD (93/42/EEC as modified by 2007/47/EC). This is skirting the edge of consulting for a third- party reviewer, but I found it was a 100% objective way to review Technical Files. I also found I could review an entire Technical File in about an hour.

What’s wrong with this approach to auditing design controls?

This approach only tells you if the elements of a Technical File are present, but it doesn’t evaluate the design process. Therefore, I supplemented my element approach with a process audit of the design change process by picking a few recent design changes that I felt were high-risk issues. During the process audit of the design change process, I sampled the review of risk management documentation, any associated process validation documentation, and the actual design change approval records. If I had time, I looked for the following types of changes: 1) vendor change, 2) specification change, and 3) process change. By doing this, I covered the following clauses in ISO 13485:2016: 7.4 (purchasing), 7.3.9 (design changes), 7.5.6 (process validation), 7.1 (risk management), and 4.2.5 (control of records).

So what is my bastardized process approach to auditing design controls missing? Clauses 7.3.1 through 7.3.10 of ISO 13485:2016 are missing. These clauses are the core of the design and development process. To address this, I would like to suggest the following process approach:

Step 1 – Define the Design Process

Identify the process owner and interview them. Do this in their office–not in the conference room. Get your answers for steps 2-7 directly from them. Ask lots of open-ended questions to prevent “yes/no” responses.

Step 2 – Process Inputs

Identify how design projects are initiated. Look for a record of a meeting where various design projects were vetted and approved for internal funding. These are inputs into the design process. There should be evidence of customer focus, and some examples of corrective actions taken based upon complaints or service trend analysis.

Step 3 – Process Outputs

Identify where Design History Files (DHF) are stored physically or electronically, and determine how the DHF is updated as the design projects progress.

Step 4 – What Resources

This is typically the step of a process audit where their auditor needs to identify “what resources” are used in the process. However, only companies that have software systems for design controls have resources dedicated to Design and Development. I have indicated this in the “Turtle Diagram” presented above.

Step 5 – With Whom, Auditing Training Records

Identify which people are assigned to the design team for a design project. Sometimes companies assign great teams. In this case, the auditor should focus on the team members that must review and approve design inputs (see Clause 7.3.2) and design outputs (see Clause 7.3.3). All of these team members should have training records for Design Control procedures and Risk Management procedures.

Step 6 – Auditing Design Controls Procedures and Forms

Identify the design control procedures and forms. Do not read and review these procedures. Auditors never have the time to do this. Instead, ask the process owner to identify specific procedures or clauses within procedures where clauses in the ISO Standard are addressed. If the process owner knows exactly where to find what you are looking for, they’re training was effective, or they may have written the procedure(s). If the process owner has trouble locating the clauses you are requesting, spend more time sampling training records.

Step 7 – Process Metrics

Ask the process owner to identify some metrics or quality objectives they are using to monitor and improve the design and development process. This is a struggle for many process owners–not just design. If any metrics are not performing up to expectations, there should be evidence of actions being taken to address this. If no metrics are being tracked by the process owner, you might review schedule compliance.

Many design projects are behind schedule, and therefore this is an important metric for most companies. Now that you have completed your “Turtle Diagram,” if you have more time to audit the design process, you can interview team members to review their role in the design process. You could also sample-specific Technical Files as I indicated above. If you are performing a thorough internal audit, I recommend doing both. To learn more about using the process approach to auditing, you can register for our webinar on the topic.

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