Curbing grave errors in medical diagnosis

Recent reviews of claims for compensation for malpractices by health practitioners show that diagnostic errors are the most common, most costly and most dangerous medical mistakes both for inpatients and outpatients.

Failure to order the appropriate laboratory tests and the application of test results are major contributors to diagnostic errors, together with quality problems with test performances.

This highlights the need to improve the quality of medical laboratory services, which can be achieved by accreditation programmes to decrease the risk of errors and improve patients’ safety.

LABORATORIES

Accreditation verifies the adherence by the laboratories to established quality and competence standards needed for accurate and reliable testing combined with staff safety.

In the developed world, accreditation is a common practice for medical laboratories, but this is not the case where there are limited resources.

A study of sub-Saharan African countries showed that 37 out of 49 had no clinical laboratories accredited to internationally recognised quality standards.

QUALITY TESTS

Kenya was listed as having eight accredited laboratories, including the one at the Aga Khan Hospital in Nairobi.

In 2011, the Aga Khan University Hospital became the first to achieve international accreditation in sub-Saharan Africa, outside of South Africa, through the South African National Accreditation System (Sanas).

This comes under the mutual recognition arrangement of the International Laboratory Accreditation Cooperation (Ilac) and gives the hospital’s laboratory international recognition.

This demonstrates that the tests carried out in the laboratory are undertaken by not only competent staff, but also by using qualified equipment, validated methods, quality supplies and in a controlled environment. The tests are right — the first time and every time.

STANDARDS
The measures put in place by implementing accreditation standards and requirements increase the confidence that results generated by the hospital’s laboratory are comparable to those from other accredited laboratories and the chances of getting wrong results are remote.

The Aga Khan University Hospital participates in external quality assessment and uses primary standards to calibrate equipment, which ensures that the results are traceable to national and international standards.

There is an established quality management system that has reduced procedural errors by preventing, ensuring timely detection and action on errors.

ACCREDITATION

The accreditation requirement of an effective continuous medical education programme helps the laboratory staff keep up-to-date with global professional development and stay on the cutting edge of technological developments in their field.

Regular accreditation assessments enhance staff discipline and a sense of professionalism, which improves performance.

The Sanas-accredited laboratory is used as a training and reference laboratory to validate new testing equipment and critical supplies prior to their being used in Kenya.

COMPLIANCE
The information generated by the Aga Khan University Hospital laboratory is also used by the government and regulators to make decisions related to protecting the health and welfare of consumers and the public.

This is also aimed at protecting the environment, developing new regulations, and national policy documents and requirements.

The information is also important in assessing compliance with regulatory and legal requirements.

Mr Kibet is an administrator, Department of Pathology, Aga Khan University Hospital.  [email protected]