Digitalization of Satellite Laboratory System of Base Hospital Warakapola, Sri Lanka
SMNSM Mallawarachchi, Chandana H Mallawarachchi, Shiranee C Wickramasinghe
Base Hospital Warakapola, Laboratory investigations, Primary level institutions, Satellite laboratory system
Citation Information :
Mallawarachchi S, Mallawarachchi CH, Wickramasinghe SC. Digitalization of Satellite Laboratory System of Base Hospital Warakapola, Sri Lanka. Int J Res Foundation Hosp Healthc Adm 2020; 8 (1):12-17.
Introduction: Investigation is a vital component of healthcare. Yet, there are many primary level institutions (PLIs) that do not have the laboratory facilities of their own. Satellite laboratory system (SLS) of Base Hospital Warakapola (BHW) was conceptualized with the aim of offering laboratory facilities for the clients of eight PLIs. The current study aimed to evaluate the impact of digitalization of SLS of BHW.
Materials and methods: The process of SLS was extensively studied. The study identified gaps in the process of SLS, BHW (Phase I), implemented the intervention of digitalization of SLS (Phase II), and evaluated the intervention after 3 months (Phase III). Both qualitative and quantitative approaches were used in the study. Patients survey, key informant interviews (KIIs), and desk review of secondary data were the instruments and techniques used. The gaps identified were delay in delivery of reports, errors in transcribing investigation results informed over the phone, poor quality of handwritten reports, and reduced customer satisfaction. The delivery of reports was improved by emailing them to PLIs, which eliminated the requirement of conveying them over the phone. The report was printed at PLIs and issued to patients. The necessary infrastructure facilities to the institutions and training to the staff on use of computers and printers and email were provided.
Results: The evaluation of interventions revealed that the availability of reports within 24 hours has improved from 82.19 to 100% significantly reducing the turnaround time of reports. The percentage of reports not collected by patients dropped from 12.92 to 2.87%. The patients’ satisfaction was improved about the availability of reports within 24 hours and convenience in cost and time spent significantly. It was noteworthy that both pre- and post-interventional level clients were satisfied about the trustworthiness of SLS. Both the staff of BHW and PLIs expressed their satisfaction with the interventions and improved turnaround time of reports. In conclusion, the project identified the gaps in the process of SLS and was able to overcome them with the interventions. The improvement in the process leads to enhanced efficiency of the SLS.
Ministry of Health - Sri Lanka, National Health Strategic Master Plan 2016 - 2025 vol. IV Health Administration & HRH [Internet]. Ministry of Health - Sri Lanka; 2016. Available from: http://www.health.gov.lk/enWeb/HMP2016-2025/Health%20%20Admin%20-%20%20HRH.pdf.
Abera RG, Abota BA, Legese MH, et al. Patient satisfaction with clinical laboratory services at Tikur anbessa specialized hospital, Addis Ababa, Ethiopia. Patient Prefer Adherence 2017;11:1181–1188. DOI: 10.2147/PPA.S132397.
Wilson ML, Fleming KA, Kuti MA, et al. Access to pathology and laboratory medicine services: a crucial gap. The Lancet 2018;391(10133):1927–1938. DOI: 10.1016/S0140-6736(18)30458-6.
Leman P, Guthrie D, Simpson R, et al. Improving access to diagnostics: an evaluation of a satellite laboratory service in the emergency department. Emerg Med J 2004;21(4):452.
Petti CA, Polage CR, Quinn TC, et al. Laboratory medicine in Africa: a barrier to effective health care. Clin Infect Dis 2006;42(3):377–382. DOI: 10.1086/499363.
Bogale AL, Kassa HB, Ali JH. Patients’ perception and satisfaction on quality of laboratory malaria diagnostic service in Amhara regional state, North West Ethiopia. Malar J [Internet] 2015;14(1):241. Available from: https://malariajournal.biomedcentral.com/articles/10.1186/s12936-015-0756-6.
Plebani M. The clinical importance of laboratory reasoning. Clin Chim Acta 1999;280(1–2):35–45. DOI: 10.1016/S0009-8981(98)00196-X.
Wright JR. The politics underlying the provision of and changes in pathology and laboratory services in the United States during the roaring twenties. Arch Pathol Lab Med 2016;140(9):983–991. DOI: 10.5858/arpa.2016-0113-HP.
Kuperman GJ, Teich JM, Tanasijevic MJ, et al. Improving response to critical laboratory results with automation: results of a randomized controlled trial. J Am Med Inform Assoc 1999;6(6):512–522. DOI: 10.1136/jamia.1999.0060512.
McQueen MJ, Bailey AJ. Hamilton health sciences laboratory program: a provider developed model for hospital, university and community laboratory services. Healthc Manage Forum 1993;6(3):35–42. DOI: 10.1016/S0840-4704(10)61104-0.
Fiesher M, Schwartz MK. Strategies of organization and service for the critical-care laboratory. Clin Chem 1990;36(8):1557–1561. DOI: 10.1093/clinchem/36.8.1557.
Kilgore ML, Steindel SJ, Smith JA. Evaluating stat testing options in an academic health center: therapeutic turnaround time and staff satisfaction. Clin Chem 1998;44(8 Pt 1):1597–1603. DOI: 10.1093/clinchem/44.8.1597.
Bandara AMS, Kavisekara HKMMB, Gamagedara NS. Evaluation on satellite laboratory network (SLS) in the district of Badulla district of Sri Lanka. Int J Sci Res Publ 2017;7(11):85–97.
Bossuyt X, Verweire K, Blanckaert N. Laboratory medicine: challenges and opportunities. Clin Chem 2007;53(10):1730–1733. DOI: 10.1373/clinchem.2007.093989.
Jacobs E, Laudin AG. The satellite laboratory and point-of-care testing. integration of information. Am J Clin Pathol 1995;104(4 Suppl 1):S33–S39.
Han H, Wang W-Y, Mao B-H. Borderline-SMOTE: a new over-Sampling method in Imbalanced data sets learning Huang D-S, Zhang X-P, Huang G-B, ed. Advances in Intelligent Computing [Internet]. Berlin, Heidelberg: Springer Berlin Heidelberg; 2005. pp. 878–887. Available from: http://link.springer.com/10.1007/11538059_91.
Ahmed R, Ahmad N, Nasir F, et al. Patients’ satisfaction and quality health services: an investigation from Private hospitals of Karachi, Pakistan. Res J Recent Sci 2014;3(7):34–38.
Singh H, Haqq ED, Mustapha N. Patients’ perception and satisfaction with health care professionals at primary care facilities in Trinidad and Tobago. Bull World Health Organ 1999;77(4):356–360.
Delaney B, Wilson S, Fitzmaurice D, et al. Near-patient tests in primary care: setting the standards for evaluation. J Health Serv Res Policy 2000;5(1):37–41. DOI: 10.1177/135581960000500109.
Goswami B, Singh B, Chawla R, et al. Turn around time (TAT) as a benchmark of laboratory performance. Indian J Clin Biochem 2010;25(4):376–379. DOI: 10.1007/s12291-010-0056-4.
Holland LL, Smith LL, Blick KE. Reducing laboratory turnaround time outliers can reduce emergency department patient length of stay: an 11-hospital study. Am J Clin Pathol 2005;124(5):672–674. DOI: 10.1309/E9QPVQ6G2FBVMJ3B.
Lee-Lewandrowski E, Corboy D, Lewandrowski K, et al. Implementation of a point-of-care satellite laboratory in the emergency department of an academic medical center. Impact on test turnaround time and patient emergency department length of stay. Arch Pathol Lab Med 2003;127(4):456–460.
Derua YA, Ishengoma DR, Rwegoshora RT, et al. Users’ and health service providers’ perception on quality of laboratory malaria diagnosis in Tanzania. Malar J 2011;10(1):78. DOI: 10.1186/1475-2875-10-78.
Petrides AK, Bixho I, Goonan EM, et al. The benefits and challenges of an Interfaced electronic health record and laboratory information system: effects on laboratory processes. Arch Pathol Lab Med 2017;141(3):410–417. DOI: 10.5858/arpa.2016-0146-OA.
Jian W-S, Hsu M-H, Sukati H, et al. LabPush: a pilot study of providing remote clinics with laboratory results via short message service (SMS) in Swaziland, Africa. Shiff C, ed. PLoS ONE 2012;7(9):e44462. DOI: 10.1371/journal.pone.0044462.