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Shempela DM, Mudenda S, Kasanga M, Daka V, Kangongwe MH, Kamayani M, Sikalima J, Yankonde B, Kasonde CB, Nakazwe R, Mwandila A, Cham F, Njuguna M, Simwaka B, Morrison L, Chizimu JY, Muma JB, Chilengi R, Sichinga K. A Situation Analysis of the Capacity of Laboratories in Faith-Based Hospitals in Zambia to Conduct Surveillance of Antimicrobial Resistance: Opportunities to Improve Diagnostic Stewardship. Microorganisms 2024; 12:1697. [PMID: 39203539 PMCID: PMC11357258 DOI: 10.3390/microorganisms12081697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 08/12/2024] [Accepted: 08/15/2024] [Indexed: 09/03/2024] Open
Abstract
Antimicrobial resistance (AMR) is a public health problem exacerbated by the overuse and misuse of antibiotics and the inadequate capacity of laboratories to conduct AMR surveillance. This study assessed the capacity of laboratories in seven faith-based hospitals to conduct AMR testing and surveillance in Zambia. This multi-facility, cross-sectional exploratory study was conducted from February 2024 to April 2024. We collected and analysed data using the self-scoring Laboratory Assessment of Antibiotic Resistance Testing Capacity (LAARC) tool. This study found an average score of 39%, indicating a low capacity of laboratories to conduct AMR surveillance. The highest capacity score was 47%, while the lowest was 25%. Only one hospital had a full capacity (100%) to utilise a laboratory information system (LIS). Three hospitals had a satisfactory capacity to perform data management with scores of 83%, 85%, and 95%. Only one hospital had a full capacity (100%) to process specimens, and only one hospital had good safety requirements for a microbiology laboratory, with a score of 89%. This study demonstrates that all the assessed hospitals had a low capacity to conduct AMR surveillance, which could affect diagnostic stewardship. Therefore, there is an urgent need to strengthen the microbiology capacity of laboratories to enhance AMR surveillance in Zambia.
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Affiliation(s)
- Doreen Mainza Shempela
- Churches Health Association of Zambia, Lusaka 10101, Zambia; (M.K.); (J.S.); (B.Y.); (C.B.K.); (A.M.); (K.S.)
| | - Steward Mudenda
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka 10101, Zambia
| | - Maisa Kasanga
- Department of Pathology and Microbiology, University Teaching Hospitals, Lusaka 10101, Zambia; (M.K.); (R.N.)
- Department of Epidemiology and Biostatistics, School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Victor Daka
- Department of Public Health, School of Medicine, Copperbelt University, Ndola 10101, Zambia;
| | | | - Mapeesho Kamayani
- Churches Health Association of Zambia, Lusaka 10101, Zambia; (M.K.); (J.S.); (B.Y.); (C.B.K.); (A.M.); (K.S.)
| | - Jay Sikalima
- Churches Health Association of Zambia, Lusaka 10101, Zambia; (M.K.); (J.S.); (B.Y.); (C.B.K.); (A.M.); (K.S.)
| | - Baron Yankonde
- Churches Health Association of Zambia, Lusaka 10101, Zambia; (M.K.); (J.S.); (B.Y.); (C.B.K.); (A.M.); (K.S.)
| | - Cynthia Banda Kasonde
- Churches Health Association of Zambia, Lusaka 10101, Zambia; (M.K.); (J.S.); (B.Y.); (C.B.K.); (A.M.); (K.S.)
| | - Ruth Nakazwe
- Department of Pathology and Microbiology, University Teaching Hospitals, Lusaka 10101, Zambia; (M.K.); (R.N.)
| | - Andrew Mwandila
- Churches Health Association of Zambia, Lusaka 10101, Zambia; (M.K.); (J.S.); (B.Y.); (C.B.K.); (A.M.); (K.S.)
| | - Fatim Cham
- Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), 1201 Geneva, Switzerland; (F.C.); (M.N.); (B.S.); (L.M.)
| | - Michael Njuguna
- Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), 1201 Geneva, Switzerland; (F.C.); (M.N.); (B.S.); (L.M.)
| | - Bertha Simwaka
- Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), 1201 Geneva, Switzerland; (F.C.); (M.N.); (B.S.); (L.M.)
| | - Linden Morrison
- Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), 1201 Geneva, Switzerland; (F.C.); (M.N.); (B.S.); (L.M.)
| | - Joseph Yamweka Chizimu
- Antimicrobial Resistance Coordinating Committee, Zambia National Public Health Institute, Lusaka 10101, Zambia; (J.Y.C.); (R.C.)
| | - John Bwalya Muma
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia;
| | - Roma Chilengi
- Antimicrobial Resistance Coordinating Committee, Zambia National Public Health Institute, Lusaka 10101, Zambia; (J.Y.C.); (R.C.)
| | - Karen Sichinga
- Churches Health Association of Zambia, Lusaka 10101, Zambia; (M.K.); (J.S.); (B.Y.); (C.B.K.); (A.M.); (K.S.)
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Garg A, Nathawat R, Singh AK, Dixit S, Acharya M. Corrective and preventive actions (CAPAs) in eye bank. Indian J Ophthalmol 2023; 71:3128-3130. [PMID: 37602597 PMCID: PMC10565914 DOI: 10.4103/ijo.ijo_1994_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/07/2023] [Indexed: 08/22/2023] Open
Abstract
This case series highlights the challenges in eye banking and the importance of a quality assurance program. Three cases triggered corrective and preventive actions (CAPAs) to improve the processes. Case 1 emphasized training to prevent retrieval failures. Case 2 stressed the need for blood samples and comprehensive documentation. In Case 3, mishandling led to policy revisions and staff training. CAPA involved identifying concerns, root cause analysis, action plans, implementation, checks, and closure. Errors can occur in man, machinery, process, and policies. Continuous CAPA ensures continuous quality improvement and safe corneal tissue transplantation, benefiting patients in need.
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Affiliation(s)
- Aastha Garg
- Department of Cornea and Anterior Segment, Dr. Shroff’s Charity Eye Hospital, New Delhi, India
| | - Rakhi Nathawat
- Department of Eye Bank, Dr. Shroff’s Charity Eye Hospital, New Delhi, India
| | - A K Singh
- Department of Quality Control, Dr. Shroff’s Charity Eye Hospital, New Delhi, India
| | - Surender Dixit
- Department of Eye Bank, Dr. Shroff’s Charity Eye Hospital, New Delhi, India
| | - Manisha Acharya
- Department of Cornea and Anterior Segment, Dr. Shroff’s Charity Eye Hospital, New Delhi, India
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Soto Lopez D, Garshasbi M, Kabir G, Bari AM, Ali SM. Evaluating interaction between internal hospital supply chain performance indicators: a rough-DEMATEL-based approach. INTERNATIONAL JOURNAL OF PRODUCTIVITY AND PERFORMANCE MANAGEMENT 2022. [DOI: 10.1108/ijppm-02-2021-0085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposePrevious studies on hospital supply chain performance have attempted to measure the performance of the hospital supply chain either by the measurement of performance indicators or the performance of specific activities. This paper attempts to measure the internal hospital supply chain's performance indicators to find their interdependencies to understand the relationship among them and identify the key performance indicators for each of those aspects of the logistics process toward improvement.Design/methodology/approachIn this research, a systematic assessment and analysis method under vagueness is proposed to assess, analyze and measure the internal health care performance aspects (HCPA). The proposed method combines the group Decision-Making and Trial Evaluation Laboratory (DEMATEL) method and rough set theory.FindingsThe study results indicate that the most critical aspects of hospital supply chain performance are completeness of treatment, clinical care process time and no delay in treatment.Originality/valueThe causal relationship from rough-DEMATEL can advise management officials that to improve the completeness of treatment toward patient safety, clinical care process time should be addressed initially and with it, patient safety aspects such as free from error, clinical care productivity, etc. should be improved as well. Improvement of these aspects will improve the other aspects they are related to.
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Paul HA, Adams BJ, Venner AA. Improving quality of transcutaneous bilirubin measurements: Value of in-house developed quality control. Pract Lab Med 2021; 24:e00206. [PMID: 33598521 PMCID: PMC7868991 DOI: 10.1016/j.plabm.2021.e00206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 01/24/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Quality assurance (QA) plays an integral role in Point of Care Testing (POCT) programs. Quality control (QC) is an important QA program component to ensure high quality results and enhanced patient care. The measurement of transcutaneous bilirubin (TcB) in the POCT setting is an essential part of newborn care in Alberta, Canada. However, there is currently no available commercial QC material for TcB meters. An in-house developed QC material has been in use within a single TcB POCT program within Alberta. The objective of this study was to determine the performance of this QC material by other POCT staff and clinical end-users to assess whether its use could be expanded. DESIGN AND METHODS Two levels of QC material were measured by POCT staff and clinical end-users across 12 different sites using the Dräger Jaundice Meter JM-103® and JM-105® meters. RESULTS The performance of the QC material was acceptable when tested by POCT staff, was stable and reliable over time, and had an acceptable CV (≤8%). However, the data does not support use of the QC material by clinical end-users. CONCLUSIONS The use of the QC material could be expanded into other TcB settings for use by POCT staff. Additional training and experience with the QC material by end-users is needed to facilitate QC use in the clinical setting.
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Affiliation(s)
- Heather Anne Paul
- Alberta Precision Laboratories, 3535, Research Rd NW, Calgary, AB, T2L 2K8, Canada
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, 3330, Hospital Drive NW, Calgary, AB, T2N 4N1, Canada
| | - Brenda Joanne Adams
- Alberta Precision Laboratories, 3535, Research Rd NW, Calgary, AB, T2L 2K8, Canada
| | - Allison Anne Venner
- Alberta Precision Laboratories, 3535, Research Rd NW, Calgary, AB, T2L 2K8, Canada
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, 3330, Hospital Drive NW, Calgary, AB, T2N 4N1, Canada
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Babyar J. Laboratory science and a glimpse into the future. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2020. [DOI: 10.1080/20479700.2019.1603276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Banković Radovanović P. Quality improvement project: Reducing non-conformities of the samples for haemostasis testing in a secondary healthcare centre through the nurses' education in phlebotomy. Biochem Med (Zagreb) 2020; 30:020708. [PMID: 32550816 PMCID: PMC7271753 DOI: 10.11613/bm.2020.020708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/13/2020] [Indexed: 12/28/2022] Open
Abstract
Introduction Poor compliance to the current guidelines and lack of knowledge among nurses about proper blood sampling is set as the study hypothesis. Here is presented a quality improvement project with following aims: a) to identify the most prevalent non-conformity of the samples for haemostasis testing, b) to identify the cause of sample non-conformity, c) to perform corrective action(s) and d) to assess the effectiveness of the corrective action(s). Materials and methods The rate of non-conformity of samples collected for haemostasis tests was established for hospital wards with inpatients. Phlebotomy practice was audited throughout anonymous questionnaire among hospital’s nurses who perform phlebotomy. Education about blood sampling was performed as a 1-hour lecture in different small groups each working day within one month. Education effectiveness was assessed through the evaluation of sample quality and is considered effective if more than half of the hospital wards significantly reduced their sample non-conformities rate. Results Clotted sample constituted 84% of sample non-conformities. The questionnaire revealed nurses’ poor knowledge in phlebotomy. There was no difference in nurses’ knowledge regarding the level of education or work experience. Reduction in sample non-conformities was observed in 7 out of 9 wards 4 months after education; this improvement was statistically significant for 5 wards. Conclusion Clotted sample as the most prevalent non-conformity of the samples for haemostasis testing is caused by the lack of knowledge of the nurses in several parts of the phlebotomy process. Specific education of the motivated personnel in small groups was successful and long-term effective.
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Church DL, Naugler C. Essential role of laboratory physicians in transformation of laboratory practice and management to a value-based patient-centric model. Crit Rev Clin Lab Sci 2020; 57:323-344. [PMID: 32180485 DOI: 10.1080/10408363.2020.1720591] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The laboratory is a vital part of the continuum of patient care. In fact, there are few programs in the healthcare system that do not rely on ready access and availability of complex diagnostic laboratory services. The existing transactional model of laboratory "medical practice" will not be able to meet the needs of the healthcare system as it rapidly shifts toward value-based care and precision medicine, which demands that practice be based on total system indicators, clinical effectiveness, and patient outcomes. Laboratory "value" will no longer be focused primarily on internal testing quality and efficiencies but rather on the relative cost of diagnostic testing compared to direct improvement in clinical and system outcomes. The medical laboratory as a "business" focused on operational efficiency and cost-controls must transform to become an essential clinical service that is a tightly integrated equal partner in direct patient care. We would argue that this paradigm shift would not be necessary if laboratory services had remained a "patient-centric" medical practice throughout the last few decades. This review is focused on the essential role of laboratory physicians in transforming laboratory practice and management to a value-based patient-centric model. Value-based practice is necessary not only to meet the challenges of the new precision medicine world order but also to bring about sustainable healthcare service delivery.
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Affiliation(s)
- Deirdre L Church
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Medicine, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
| | - Christopher Naugler
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
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Homolka S, Zallet J, Albert H, Witt AK, Kranzer K. Introduction of quality management in a National Reference Laboratory in Germany. PLoS One 2019; 14:e0222925. [PMID: 31613905 PMCID: PMC6793863 DOI: 10.1371/journal.pone.0222925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 09/10/2019] [Indexed: 11/19/2022] Open
Abstract
Background High quality diagnostic services are crucial for tuberculosis (TB) diagnosis, treatment and control. A strong laboratory quality management system (QMS) is critical to ensuring the quality of testing and results. Recent initiatives to improve TB laboratory quality have focused on low and middle-income countries, but similar issues also apply to high-income countries. Methods and findings Using a multipronged approach reviews of facilities, equipment, processes (purchasing, pre-analytic, analytic and post-analytic), staff, health and safety, documentation, information management and organization based on the ISO 15189 and the twelve quality system essentials were conducted between October 2015 and January 2016 at the National TB Reference Laboratory in Germany. Outcome assessment included proportion of smear positive slides, proportion of contaminated liquid cultures and DNA contamination rates before and after implementation of QMS. The odds ratio for these outcomes was calculated using a before/after comparison. Reviews highlighted deficiencies across all twelve quality system essentials and were addressed in order of priority and urgency. Actions aimed at improving analytical quality, health and safety and information management were prioritised for initial implementation in parallel with each other. The odds ratio for a sample to be tested as microscopically positive increased by 2.08 (95%CI 1.41–3.06) comparing the time before with the time after implementation of quality managed fluorescence microscopy. Liquid culture contamination rates decreased from 23.6- 7.6% in April-July 2016 to <10% in November 2017-March 2018. The proportion of negative controls showing evidence of DNA contamination decreased from 38.2% in 2013 to 8.1% in 2017, the corresponding odds ratio was 0.14 (95%CI 0.07–0.29). Conclusion This study showed marked improvement on quality indicators after implementation of a QMS in a National TB Reference Laboratory. The challenges and lessons learned in this study are valuable not just for high-income settings, but are equally generalizable to other laboratories.
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Affiliation(s)
- Susanne Homolka
- National Reference Laboratory for Mycobacteria, Research Center Borstel, Borstel, Germany
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
- * E-mail:
| | - Julia Zallet
- National Reference Laboratory for Mycobacteria, Research Center Borstel, Borstel, Germany
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
| | - Heidi Albert
- Foundation for Innovative New Diagnostics (FIND) South Africa, Cape Town, South Africa
| | - Anne-Kathrin Witt
- National Reference Laboratory for Mycobacteria, Research Center Borstel, Borstel, Germany
| | - Katharina Kranzer
- National Reference Laboratory for Mycobacteria, Research Center Borstel, Borstel, Germany
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, England, United Kingdom
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Keckler M, Anderson K, McAllister S, Rasheed J, Noble-Wang J. Development and implementation of evidence-based laboratory safety management tools for a public health laboratory. SAFETY SCIENCE 2019; 117:205-216. [PMID: 31156293 PMCID: PMC6537614 DOI: 10.1016/j.ssci.2019.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We developed an evidence-based continuous quality improvement (CQI) cycle for laboratory safety as a method of utilizing survey data to improve safety in a public health laboratory setting. • Expert Opinion: The CQI cycle begins with the solicitation of laboratory staff input via an annual survey addressing potential chemical, physical and radiological hazards associated with multiple laboratory activities. The survey collects frequency, severity and exposure data related to these activities in the context of the most pathogenic organisms handled at least weekly. • Gap Analysis: Step 2 of the CQI cycle used survey data to identify areas needing improvement. Typically, the traditional two-dimensional risk assessment matrix is used to prioritize mitigations. However, we added an additional dimension - frequency of exposure - to create three-dimensional risk maps to better inform and communicate risk priorities. • Mitigation Measures: Step 3 of the CQI cycle was to use these results to develop mitigations. This included evaluating the identified risks to determine what risk control measures (elimination, substitution, engineering, administrative or PPE) were needed. In the 2016 iteration of the CQI cycle described here, all mitigations were based on administrative controls. • Evaluation and Feedback: The last step of the CQI cycle was to evaluate the inferred effects of interventions through subsequent surveys, allowing for qualitative assessment of intervention effectiveness while simultaneously restarting the cycle by identifying new hazards. Here we describe the tools used to drive this CQI cycle, including the survey tool, risk analysis method, design of interventions and inference of mitigation effectiveness.
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Affiliation(s)
- M.S. Keckler
- Centers for Disease Control and Prevention, National Center for Emerging Zoonotic and Infectious Diseases, Division of Healthcare Quality Promotion, Clinical and Environmental Microbiology Branch, United States
- Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services, Laboratory Leadership Service Fellowship, United States
| | - K. Anderson
- Centers for Disease Control and Prevention, National Center for Emerging Zoonotic and Infectious Diseases, Division of Healthcare Quality Promotion, Clinical and Environmental Microbiology Branch, United States
| | - S. McAllister
- Centers for Disease Control and Prevention, National Center for Emerging Zoonotic and Infectious Diseases, Division of Healthcare Quality Promotion, Clinical and Environmental Microbiology Branch, United States
| | - J.K. Rasheed
- Centers for Disease Control and Prevention, National Center for Emerging Zoonotic and Infectious Diseases, Division of Healthcare Quality Promotion, Clinical and Environmental Microbiology Branch, United States
| | - J. Noble-Wang
- Centers for Disease Control and Prevention, National Center for Emerging Zoonotic and Infectious Diseases, Division of Healthcare Quality Promotion, Clinical and Environmental Microbiology Branch, United States
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Albert H, de Dieu Iragena J, Kao K, Erni D, Mekonen T, Onyebujoh PC. Implementation of quality management systems and progress towards accreditation of National Tuberculosis Reference Laboratories in Africa. Afr J Lab Med 2017; 6:490. [PMID: 28879161 PMCID: PMC5523922 DOI: 10.4102/ajlm.v6i2.490] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 10/07/2016] [Indexed: 12/02/2022] Open
Abstract
Background Laboratory services are essential at all stages of the tuberculosis care cascade, from diagnosis and drug resistance testing to monitoring response to treatment. Enabling access to quality services is a challenge in low-resource settings. Implementation of a strong quality management system (QMS) and laboratory accreditation are key to improving patient care. Objectives The study objective was to determine the status of QMS implementation and progress towards accreditation of National Tuberculosis Reference Laboratories (NTRLs) in the African Region. Method An online questionnaire was administered to NTRL managers in 47 World Health Organization Regional Office for Africa member states in the region, between February and April 2015, regarding the knowledge of QMS tools and progress toward implementation to inform strategies for tuberculosis diagnostic services strengthening in the region. Results A total of 21 laboratories (43.0%) had received SLMTA/TB-SLMTA training, of which 10 had also used the Global Laboratory Initiative accreditation tool. However, only 36.7% of NTRLs had received a laboratory audit, a first step in quality improvement. Most NTRLs participated in acid-fast bacilli microscopy external quality assurance (95.8%), although external quality assurance for other techniques was lower (60.4% for first-line drug susceptibility testing, 25.0% for second-line drug susceptibility testing, and 22.9% for molecular testing). Barriers to accreditation included lack of training and accreditation programmes. Only 28.6% of NTRLs had developed strategic plans and budgets which included accreditation. Conclusion Good foundations are in place on the continent from which to scale up accreditation efforts. Laboratory audits should be conducted as a first step in developing quality improvement action plans. Political commitment and strong leadership are needed to drive accreditation efforts; advocacy will require clear evidence of patient impact and cost-benefit.
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Affiliation(s)
| | | | | | | | - Teferi Mekonen
- African Society for Laboratory Medicine, Addis Ababa, Ethiopia
| | - Philip C Onyebujoh
- World Health Organisation, African Region Country Office, Harare, Zimbabwe
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Abstract
Customer satisfaction is the most important parameter for judging the quality of service being provided by a service provider to the customer. Positive feedback from the customer leads to the goodwill of service providers in the market, which indirectly expands their business, whereas negative feedback makes it shrink. This theory is also applicable to health care providers. Nowadays, patients are aware of their rights in terms of health care services and the quality of health care services being delivered to them. There are various tools or indicators which are set to provide the quality of services for patients without any acquired infection. In this article, literature review has been done to study various tools given by distinct authors and customer satisfaction and quality indicators given by health organizations to measure quality in the health care sector.
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Nikolac N, Celap I, Filipi P, Hemar M, Kocijancic M, Miler M, Simundic AM, Smolcic VS, Vrtaric A. Croatian laboratories have a good knowledge of the proper detection and management of hemolyzed, icteric and lipemic samples. ACTA ACUST UNITED AC 2016; 54:419-25. [DOI: 10.1515/cclm-2015-0650] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 08/28/2015] [Indexed: 11/15/2022]
Abstract
AbstractEndogenous interferences are an important source of biased laboratory results. Hemolysis, lipemia and icteria are the main source of endogenous interference in laboratory medicine. Accreditation according to ISO 15189 improves the overall quality of the laboratory procedures. The aim of our study was i) to assess the level of knowledge of Croatian medical biochemists about the proper detection and management of hemolysis, lipemia and icteria; and ii) to identify possible differences in the level of knowledge respective to the laboratory accreditation status.An on-line self-report survey was carried out by the Working Group for Preanalytical Phase of the Croatian Society of Medical Biochemistry and Laboratory Medicine during April to May 2015. Survey included 14 statements (Q1–Q14) about procedures for samples with interferences and participants were asked to assess the degree of agreement with the statement using a 4-point Likert scale.The lowest level of knowledge was observed for statements Q10 (dealing with icteric sample; 40.9% participants agreed with the correct procedure), Q12 (allowable error for interference; 47.2%) and Q11 (dealing with lipemic sample; 60.1%). Almost all participants (97.4%) agreed that laboratories in Croatia should have a harmonized protocol for management of samples with interferences. Participants from accredited laboratories showed higher knowledge of hemolysis detection (p=0.031), rejection of hemolyzed sample (p<0.001), management of icteric samples (p=0.038) and allowable error for interferences (p=0.040).Croatian laboratories have a good knowledge of the proper detection and management of hemolyzed, icteric and lipemic samples. Accreditation is associated with higher knowledge about management of samples with interferences.
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Long-Mira E, Washetine K, Hofman P. Sense and nonsense in the process of accreditation of a pathology laboratory. Virchows Arch 2015; 468:43-9. [PMID: 26334197 DOI: 10.1007/s00428-015-1837-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 07/25/2015] [Accepted: 08/13/2015] [Indexed: 10/23/2022]
Abstract
The aim of accreditation of a pathology laboratory is to control and optimize, in a permanent manner, good professional practice in clinical and molecular pathology, as defined by internationally established standards. Accreditation of a pathology laboratory is a key element in fine in increasing recognition of the quality of the analyses performed by a laboratory and in improving the care it provides to patients. One of the accreditation standards applied to clinical chemistry and pathology laboratories in the European Union is the ISO 15189 norm. Continued functioning of a pathology laboratory might in time be determined by whether or not it has succeeded the accreditation process. Necessary requirements for accreditation, according to the ISO 15189 norm, include an operational quality management system and continuous control of the methods used for diagnostic purposes. Given these goals, one would expect that all pathologists would agree on the positive effects of accreditation. Yet, some of the requirements stipulated in the accreditation standards, coming from the bodies that accredit pathology laboratories, and certain normative issues are perceived as arduous and sometimes not adapted to or even useless in daily pathology practice. The aim of this review is to elaborate why it is necessary to obtain accreditation but also why certain requirements for accreditation might be experienced as inappropriate.
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Affiliation(s)
- Elodie Long-Mira
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, University of Nice Sophia Antipolis, 30 Voie Romaine, 06001, Nice, Cedex 01, France
| | - Kevin Washetine
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, University of Nice Sophia Antipolis, 30 Voie Romaine, 06001, Nice, Cedex 01, France.,Hospital-Related Biobank (BB-0033-00025), Biobank06, Pasteur Hospital, University of Nice Sophia Antipolis, Nice, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, University of Nice Sophia Antipolis, 30 Voie Romaine, 06001, Nice, Cedex 01, France. .,Hospital-Related Biobank (BB-0033-00025), Biobank06, Pasteur Hospital, University of Nice Sophia Antipolis, Nice, France.
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Komasawa N, Sanuki T, Fujiwara S, Haba M, Ueki R, Kaminoh Y, Minami T. Significance of debriefing methods in simulation-based sedation training courses for medical safety improvement in Japan. SPRINGERPLUS 2014; 3:637. [PMID: 25392805 PMCID: PMC4218926 DOI: 10.1186/2193-1801-3-637] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 10/20/2014] [Indexed: 12/27/2022]
Abstract
Based on the American Society of Anesthesiologists' Practice Guidelines for Sedation and Analgesia by Non-Anesthesiologists (ASA-SED), a sedation training course aimed at improving medical safety was developed by the Japanese Association for Medical Simulation in 2011. This study evaluated the effect of debriefing on participants' perceptions of the essential points of the ASA-SED. A total of 38 novice doctors participated in the sedation training course during the research period. Of these doctors, 18 participated in the debriefing group, and 20 participated in non-debriefing group. Scoring of participants' guideline perceptions was conducted using an evaluation sheet (nine items, 16 points) created based on the ASA-SED. The debriefing group showed a greater perception of the ASA-SED, as reflected in the significantly higher scores on the evaluation sheet (median, 16 points) than the control group (median, 13 points; p < 0.05). No significant differences were identified before or during sedation, but the difference after sedation was significant (p < 0.05). Debriefing after sedation training courses may contribute to better perception of the ASA-SED, and may lead to enhanced attitudes toward medical safety during sedation and analgesia.
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Affiliation(s)
- Nobuyasu Komasawa
- />Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsukishi City, Osaka, 569-8686 Japan
| | - Takuro Sanuki
- />Department of Dental Anesthesiology, Nagasaki University, Sakamoto 1-7-1, Nagasaki City, Nagasaki, 852-8588 Japan
| | - Shunsuke Fujiwara
- />Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsukishi City, Osaka, 569-8686 Japan
| | - Masanori Haba
- />Department of Anesthesiology, Wakayama Red Cross Hospital, Komatsubara 4-20, Wakayama City, Wakayama, 640-8558 Japan
| | - Ryusuke Ueki
- />Department of Anesthesiology, Hyogo College of Medicine, Mukogawa-cho, Nisinomiya City, Hyogo, 663-8501 Japan
| | - Yoshiroh Kaminoh
- />Division of Anesthesiology, Social Insurance Kinan Hospital, Shinjo-cho, Tanabe City, Wakayama, Japan
| | - Toshiaki Minami
- />Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsukishi City, Osaka, 569-8686 Japan
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