Evaluation of Laboratory Performance with Quality Indicators in Infectious Disease Hospital, Kano, Nigeria
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Author(s)
Feyisayo Ebenezer Jegede1, Henry Akwen Mbah1*, Mansur Aminu2, Timothy Nathaniel Yakubu1, Kwasi Torpey1
Affiliation(s)
1Family Health International (FHI360), Abuja, Nigeria.
2Infectious Disease Hospital Laboratory, Kano, Nigeria.
2Infectious Disease Hospital Laboratory, Kano, Nigeria.
ABSTRACT
Background:
In January 2010, the implementation of quality management systems
toward WHO-AFRO laboratory accreditation commenced in the Antiretroviral
Treatment Laboratory of the Infectious Disease Hospital, Kano, Nigeria.
Quality improvement projects were instituted in 2011 in line with ISO
15189 requirements for accreditation of medical laboratory. In this
study we evaluated the performance of the laboratory through some set of
quality indicators (QI). Methodology: This was a retrospective study to
evaluate laboratory QIs monitored from January 2011 to December 2013.
The QIs were specimen rejection rate (SSR), turnaround time (TAT),
proficiency testing performance (PTP) and client satisfaction survey
(CSS). Data was collected into an excel file for analysis and percentage
performance compared among years. SSR & TAT were evaluated with the
Sigma scale. Results: A total of 7920 (2194 in 2011, 2715 in 2012, 3011
in 2013) specimens were received for testing. 22 (0.28%) specimens were
rejected and 81 (1.02%) specimens’ results were reported after the
acceptable TAT, giving a Sigma level of 4.27 and 3.82 for SSR and TAT
respectively. There was steady improvement in PTP: CD4+ from 67% in 2011
to 90% in 2013, hematology from 81% in 2012 to 83% in 2013, blood film
reading 79% in 2011 to 83% in 2013 and chemistry from 90% in 2011 to 93%
in 2013. HIV serology recorded 100% throughout. CSS increased from 59%
in 2012 to 78% in 2013. However, there was no statistically significance
difference reported for PTP and CSS over the years (P > 0.05).
Conclusion: The study highlights the need to continuously evaluate QIs
and calls for more effort to improve on PTP and focuses on understanding
and improving on clients concerns.
Cite this paper
References
Jegede,
F. , Mbah, H. , Aminu, M. , Yakubu, T. and Torpey, K. (2015) Evaluation
of Laboratory Performance with Quality Indicators in Infectious Disease
Hospital, Kano, Nigeria. Open Journal of Clinical Diagnostics, 5, 1-9. doi: 10.4236/ojcd.2015.51001.
| [1] | WHO (2008) Strengthening Public Health Laboratories in the WHO African Region: A Critical Need for Disease Control. 58th Session of the WHO Regional Committee for Africa (AFR/RC58/R2), World Health Organization Regional Office for Africa, Yaounde. |
| [2] | Bonini, P., Plebani, M., Ceriotti, F. and Rubboli, F. (2002) Errors in Laboratory Medicine. Clinical Chemistry, 48, 691-698. |
| [3] | Agarwal,
R., Chaturvedi, S., Chhillar, N., Goyal, R., Pant, I. and Tripathi,
C.B. (2012) Role of Intervention on Laboratory Performance: Evaluation
of Quality Indicators in a Tertiary Care Hospital. Indian Journal of
Clinical Biochemistry, 27, 61-68. http://dx.doi.org/10.1007/s12291-011-0182-7 |
| [4] | International
Organization for Standardization (2012) ISO 15189: Medical Laboratories
Requirements for Quality and Competence. Geneva. http://www.iso.org |
| [5] | Salinas,
M., López-Garrigós, M., Gutiérrez, M., Lugo, J. and Uris, J. (2010) Two
Minutes of Monthly Monitoring Can Ensure Quality Laboratory Service
Every Day of the Year. Lab Medicine, 41, 360-363. http://dx.doi.org/10.1309/LM8OI14LCORJYHVY |
| [6] | Audu,
R.A., Sylvester-Ikondu, U., Onwuamah, C.K., Salu, O.B., Ige, F.A.,
Meshack, E., et al. (2011) Experience of Quality Management System in a
Clinical Laboratory in Nigeria. African Journal of Laboratory Medicine,
1, 1-5. http://dx.doi.org/10.4102/ajlm.v1i1.18 |
| [7] | Jegede,
F.E., Mbah, H.A., Yakubu, T.N., Adedokun, O., Negedu-momoh, O.R. and
Torpey, K. (2014) Laboratory Quality Audit in 25 Anti-Retroviral Therapy
Facilities in North West of Nigeria. Open Journal of Clinical
Diagnostics, 4, 193-204. http://dx.doi.org/10.4236/ojcd.2014.44028 |
| [8] | Gershy-Damet,
G.-M., Rotz, P., Cross, D., Belabbes, E.H., Cham, F., Ndihokubwayo,
J.-B., et al. (2010) The World Health Organization African Region
Laboratory Accreditation Process: Improving the Quality of Laboratory
Systems in the African Region. American Journal of Clinical Pathology,
134, 393-400. http://dx.doi.org/10.1309/AJCPTUUC2V1WJQBM |
| [9] | Yao,
K., McKinney, B., Murphy, A., Rotz, P., Wafula, W., Sendagire, H.,
Okui, S. and Nkengasong, J.N. (2010) Improving Quality Management
Systems of Laboratories in Developing Countries: An Innovative Training
Approach to Accelerate Laboratory Accreditation. American Journal of
Clinical Pathology, 134, 401-409. http://dx.doi.org/10.1309/AJCPNBBL53FWUIQJ |
| [10] | Mbah,
H., Ojo, E., Ameh, J., Musuluma, H., Negedu-Momoh, O.R., Jegede, F., et
al. (2014) Piloting Laboratory Quality System Management in Six Health
Facilities in Nigeria. PLoS ONE, 9, e116185. http://dx.doi.org/10.1371/journal.pone.0116185 |
| [11] | UNI 11097 (2003) Quality Management—Quality Indicators and Quality Management Synoptical Tables—General Guidelines. |
| [12] | Shahangian,
S. and Snyder, S.R. (2009) Laboratory Medicine Quality Indicators.
American Journal of Clinical Pathology, 131, 418-431. http://dx.doi.org/10.1309/AJCPJF8JI4ZLDQUE |
| [13] | Nevalainen, D., Berte, L., Kraft, C., Leigh, E., Picaso, L. and Morgan, T. (2000) Evaluating Laboratory Performance on Quality Indicators with the Six Sigma Scale. Archives of Pathology & Laboratory Medicine, 124, 516-519. |
| [14] | Westguard, S. (2011) 113 Improve Lab Operations with Six Sigma Metrics. American Society for Clinical Pathology, Chicago. |
| [15] | Nanda, S.K. and Ray, L. (2013) Quantitative Application of Sigma Metrics in Medical Biochemistry. Journal of Clinical and Diagnostic Research, 7, 2689-2691. |
| [16] | Coskun, A., Inal, T., Unsal, I. and Serteser, M. (2007) Six Sigma as a Quality Management Tool: Evaluation of Performance in Laboratory Medicine. In: Coskun, A., Ed., Quality Management and Six Sigma, Sciyo, Rijeka,247-263. |
| [17] | Coskun, A. (2006) Six Sigma and Calculated Laboratory Tests. Clinical Chemistry, 52, 770-771. http://dx.doi.org/10.1373/clinchem.2005.064311 |
| [18] | Baker, A. (2001) Crossing the Quality Chasm: A New Health System for the 21st Century. British Medical Journal, 323, 1192. http://dx.doi.org/10.1136/bmj.323.7322.1192 |
| [19] | Rowe,
A.K., De Savigny, D., Lanata, C.F. and Victora, C.G. (2005) How Can We
Achieve and Maintain High-Quality Performance of Health Workers in
Low-Resource Settings? The Lancet, 366, 1026-1035. http://dx.doi.org/10.1016/S0140-6736(05)67028-6 |
| [20] | Guimaraes,
A.C., Wolfart, M., Brisolara, M.L.L. and Dani, C. (2012) Causes of
Rejection of Blood Samples Handled in the Clinical Laboratory of a
University Hospital in Porto Alegre. Clinical Biochemistry, 45, 123-126.
http://dx.doi.org/10.1016/j.clinbiochem.2011.10.009 |
| [21] | Jacobsz,
L.A., Zemlin, A.E., Roos, M.J. and Erasmus, R.T. (2011) Chemistry and
Haematology Sample Rejection and Clinical Impact in a Tertiary
Laboratory in Cape Town. Clinical Chemistry and Laboratory Medicine, 49,
2047-2050. http://dx.doi.org/10.1515/CCLM.2011.743 |
| [22] | Lippi,
G., Blanckaert, N., Bonini, P., Green, S., Kitchen, S., Palicka, V.,
Vassault, A.J. and Plebani, M. (2008) Haemolysis: An Overview of the
Leading Cause of Unsuitable Specimens in Clinical Laboratories. Clinical
Chemistry and Laboratory Medicine, 46, 764-772. http://dx.doi.org/10.1515/CCLM.2008.170 |
| [23] | Mbah, H.A. (2014) Phlebotomy and Quality in the African Laboratory. African Journal of Laboratory Medicine, 3, 4-7. http://dx.doi.org/10.4102/ajlm.v3i1.132 |
| [24] | Hawkins, R.C. (2007) Laboratory Turnaround Time. Clinical Biochemist Reviews, 28, 179-194. |
| [25] | Goswami,
B., Singh, B., Chawla, R., Gupta, V.K. and Mallika, V. (2010) Turn
Around Time (TAT) as a Benchmark of Laboratory Performance. Indian
Journal of Clinical Biochemistry, 25, 376-379. http://dx.doi.org/10.1007/s12291-010-0056-4 |
| [26] | Westgard,
J.O. and Westgard, S.A. (2006) The Quality of Laboratory Testing Today:
An Assessment of σ Metrics for Analytic Quality Using Performance Data
from Proficiency Testing Surveys and the CLIA Criteria for Acceptable
Performance. American Journal of Clinical Pathology, 125, 343-354. http://dx.doi.org/10.1309/V50H4FRVVWX12C79 |
| [27] | Chassin, M.R. (1998) Is Health Care Ready for Six Sigma Quality? Milbank Quarterly, 76, 565-591, 510. |
| [28] | Audu,
R.A., Onubogu, C.C., Okoye, R.N., Nwokoye, N.N., Onwuamah, C.K., Musa,
A.Z., et al. (2014) Proficiency Testing for HIV, Tuberculosis and
Malaria Diagnosis in Clinical Laboratories in Nigeria. African Journal
of Laboratory Medicine, 3, 1-9. http://dx.doi.org/10.4102/ajlm.v3i1.102 |
| [29] | Ibrahim, F., Dosoo, D., Kronmann, K.C., Ouedraogo, I., Anyorigiya, T., Abdul, H., Sodiomon, S., Owusu-Agyei, S. and Koram, K. (2012) Good Clinical Laboratory Practices Improved Proficiency Testing Performance at Clinical Trials Centers in Ghana and Burkina Faso. PLoS ONE, 7, e39098. |
| [30] | Kumasaka, K. (1998) External Quality Assessment for Clinical Microbiology and Good Laboratory Management. Japanese Journal of Clinical Pathology, 46, 124-131. |
| [31] | Ntshambiwa,
K., Ntabe-Jagwer, W., Kefilwe, C., Samuel, F. and Moyo, S. (2014)
Translating a National Laboratory Strategic Plan into Action through
SLMTA in a District Hospital Laboratory in Botswana. African Journal of
Laboratory Medicine, 3, 1-5. http://dx.doi.org/10.4102/ajlm.v3i2.209 |
| [32] | Iliyasu, Z., Abubakar, I.S., Abubakar, S., Lawan, U.M. and Gajida, A.U. (2010) Patients’ Satisfaction with Services Obtained from Aminu Kano Teaching Hospital, Kano, Northern Nigeria. Nigerian Journal of Clinical Practice, 13, 371-378. |
| [33] | Mindaye,
T. and Taye, B. (2012) Patients Satisfaction with Laboratory Services
at Antiretroviral Therapy Clinics in Public Hospitals, Addis Ababa,
Ethiopia. BMC Research Notes, 5, 184. http://dx.doi.org/10.1186/1756-0500-5-184 |
| [34] | Glick,
P. (2009) How Reliable Are Surveys of Client Satisfaction with
Healthcare Services? Evidence from Matched Facility and Household Data
in Madagascar. Social Science & Medicine, 68, 368-379. http://dx.doi.org/10.1016/j.socscimed.2008.09.053 |
| [35] | Mbah,
H., Negedu-Momoh, O.R., Adedokun, O., Ikani, P.A., Balogun, O., Sanwo,
O., Ochei, K., Ekanem, M. and Torpey, K. (2014) Implementing and
Measuring the Level of Laboratory Service Integration in a Program
Setting in Nigeria. PLoS ONE, 9, e107277. http://dx.doi.org/10.1371/journal.pone.0107277 eww150213lx |
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