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Clinical laboratory services are a critical yet much neglected component of health systems in resource poor countries. They are crucial for public health, disease control and surveillance, and guide patient diagnosis and care, but their key role is often not recognized by governments or donors. Laboratory tests should be used to improve the outcome for individual patients or to provide public health information. However, if the quality of laboratory tests is poor, resources will be wasted on repeat tests or inappropriate management and the laboratory service will be inefficient.
The primary goal of Laboratory Medicine is to provide information that is useful to assist medical decision-making, allowing optimal health care. This can only be obtained by generating reliable analytical results on patient samples. Meaningful measurements are indeed essential for the diagnosis, monitoring, treatment, and risk assessment of patients. Inadequate laboratory performance may have extensive consequences for practical medicine, healthcare system, and, in conclusion, for the patient. Poor quality results may actually lead to incorrect interpretation by the clinician, impairing the patient’s
Accreditation authorities have identified twelve quality system essentials that need to be in place for a laboratory to perform clinical tests adequately and in a quality assured manner. Along with each laboratory performing tests that are in its scope, it is essential that duplication and excess capacity is addressed by forging and operating a network of laboratories leading to consolidation and integration of clinical testing. A network would have collection centers at places convenient to the patients, supported by frequent transfer of samples in appropriate conditions to the laboratory. In the laboratory there is a need for increased automation and relevant training of personnel and the setting up of centralized accessioning, pneumontic chutes for transport of samples to the work bench and for bidirectional interphased equipment to transfer results to desk top of laboratory physicians and after validation of results for the results to be electronically transferred by SMS and/or PDF files via email and/or becoming available online for clients, supplemented by delivery of hard copies of the results.
The challenge in the next decade for laboratory medicine is to accomplish these major changes in organization to meet fiscal restraint and shortage of adequately trained laboratory personnel. Collaborative networks, constructive use of point of care devices, and the development of rapport between laboratories and their clients leading to cost effective utilization of limited resources, are some of the strategies that will maximize patient benefit