Centralization is the basis for laboratory service reformation in Astana

EXPERIENCE and PERSPECTIVES

Leading specialist Laboratory Service Health Department in Astana

Zh. Suleimenova

CENTRALIZATION IS A WAY OF ORGANIZING ONE OF MEDICAL SERVICES (LABORATORY SERVICE) ACCORDING TO PLACE IN ORDER TO DECREASE COSTS RELATED TO INCREASED VOLUME OF PRODUCTIVITY.

A.A. KISHKUN – “NATIONAL DAYS OF LABORATORY MEDICINE” MOSCOW (RUSSIA) 24TH SEPTEMBER 2015

GLOSSARY

International experience and tendencies in laboratory service market

Total quality management – Introduction of quality management system based on

international experience ISO 15189 – 2012

Ensuring biological safety – WHO, CDC recommendations

Centralization of laboratory researchautomatization of producing laboratory

research – in developed countries – England, France, Germany, Italy, Japan

Laboratory service reformation program in Astana

1 step – Centralization on ambulatory-polyclinic level – 2011

2 step – Centralization of laboratories on hospital level -

2016

Centralization on ambulatory-polyclinic level #4 City polyclinic

ГП – 10ЦПМСП – 6

Blood chemistry – 40

Immunochemistry - 82PCR - 6

HISTORY

2011 - 2012 • Opening of the Center of laboratory technologies• Creating laboratory doctors society• Creating clinical basis for JSC “Medical university Astana”

2013 – 2014 • Republican conference “Medical laboratory management”• Certification for ISO 9001-2008 standard

2015• Participation in the international assessing expert

group CLSI in support of Center for Disease Control and Prevention in Central Asia CDC (USA)

#4 City polyclinic

International external research quality assessment

Quality certificates: general clinical, hematological, biochemical, immunoenzymatic

and PCR research. Based on external quality assessment conducted

by the USA, the UK, France, Republic Kazakhstan among the best 4 laboratories

Laboratory service development perspectives in Astana

Optimization clinical-diagnostic laboratories in hospitals and ambulatory medical organizations – maximum service centralization.

Introduction of centralized quality management system in laboratory research and performance indicators assessment system in laboratory service

Creating unified price space for out-of-pocket paid laboratory analysis in net of medical organizations Health department in Astana

Improvement of human resources via professional staff training at work

Standardization and implementation of advanced technological methods in laboratory diagnostics, laboratory research succession planning

Centralized laboratory testing quality assurance governance

Laboratory technologies center

Organizing performance indicators assessment system based on key

performance indicators (KPI) within jurisdictional and subcontracted clinical-

diagnostic laboratories in medical organizations in Astana

Implementation of external quality control program through inter-laboratory

comparison

Organizing and conducting expert testing in complicated cases

Creating unified database for laboratory data

Implementation of Targeted quality assurance indicators in laboratory diagnostics

PRE-ANALYTICAL STAGE

Errors in identification 0,1%

Number of unusable samples for testing, transportation and storage

0,1%

Hemolyzed samples 0,06%

ANALYTICAL STAGE

Intra-laboratory quality control coverage 95%

Number of tests with unacceptable results according to variation coefficient

7 %

External quality assessment coverage 75%

POST-ANALYTICAL STAGE

Inappropriate ТАТ 95%

Critical data message 99,9%

Creatinine 3,15

Glucose 3,7

Urea 4,2

Erythrocyte 0,93

Leucocyte 1,97

Intra-laboratory controlMatching control

reproducibility and accuracy

1 level

2 level

3 level

Biosample collection places with ИМЛ

Specialized МЛ

Centralized МЛ

Expert laboratory

1. Centralization of laboratory services in medical organizations according to

specialization2. Opening Centralized laboratory’s

branches in medical organizations3. Creating specialized laboratory net in

specialized medical centers

1. Preparation of regulation (normative) documents

2. Development of centralized governance system МЛ

3. Unified tariff approval4. Openning biosample collection

places in medical organizations in Astana

5. Accreditation of Centralized laboratory

IMPLEMENTATION STEPS2015

2016