1.Steering Standardization of Pathology Services Through Centralisation and Consolidation of Laboratory Procurement
Salbiah Isa ; Mohd Jamsani Mat Salleh ; Hakimah Mahsin
Malaysian Journal of Medicine and Health Sciences 2023;19(No.1):280-285
The expansion of healthcare services to serve as many people as possible has led to the decentralisation of laboratory
testing. Many laboratory tests are now made available at district hospitals and rural health clinics for certain states
or provinces. Consequently, there is a proliferation of laboratory tests, techniques, equipment, and other required
commodities at the different medical laboratories. The lack of central governance has resulted in a widely-diverse
and non-standardised laboratory services that may eventually affect the quality of healthcare delivery to patients.
To ensure a high-quality and standardised healthcare delivery across a state or a province, it is important that the
relevant stakeholders outline and implement the necessary strategies to establish a streamlined medical laboratory
network. In this article, we discuss the significance of laboratory procurement consolidation and centralisation in the
steering of the standardisation of laboratory operations leading to a high-quality and efficient chemical pathology
services in a defined region.
2.Improvement of Urgent Tests Laboratory Turnaround Time Through Laboratory Lean Management
Salbiah Isa ; Rohayu Hami ; Hanita Hashim ; Mohd Nizam S. ; Harani MS. ; Sairi S. ; Mohd Jamsani Mat Salleh
Malaysian Journal of Medicine and Health Sciences 2020;16(Supp 2, May):15-21
Introduction: Laboratory turnaround time (LTAT) is considered a reliable indicator of the quality and efficiency of a laboratory’s service. LTAT achievement, particularly of urgent tests, remains unsatisfactory and challenging in many clinical laboratories especially in tertiary health care centres with high workload and restricted resources. The unresolved issue of unsatisfactory urgent renal profile (RP) LTAT below the standard performance goal prompted our interest to improve laboratory’s handling of urgent test request. We thus implemented the Lean principle in the management of urgent test requests using urgent RP as the test model. Methods: The implementation of laboratory Lean involved 4 steps process; (1) Development of burning platform for change (2) Identification of waste (3) Planning and implementation of control measures (4) Measuring, monitoring, and sustaining the improvement. Urgent RP LTAT and the percentage of the request met the time requirement determined based on the data extracted from laboratory information system (LIS) before and after the implementation of Lean was compared to assess the effectiveness. Results: Urgent RP LTAT after the implementation of Lean was reduced i.e 35 min (before) vs 31 min (after), with the percentage of LTAT met the time requirement was significantly increased above the set target i.e 82.8% (before) to 93.5% (after) with P-value = 0.001. Conclusion: Implementation of innovation using Lean management has significantly improved urgent RP LTAT achievement, thus optimised urgent test management in our Chemical Pathology laboratory. Lean is a strongly recommended strategy to improve urgent test LTAT especially in laboratories with restricted resources.