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Errors in diagnosis are the most common and dangerous medical mistakes

<div><span style="font-family: helvetica;"><img src="/nairobi/PublishingImages/errors%20in%20diagnosis%20-%20body.jpg" alt="" style="margin: 5px;"/> </span></div><div><span style="font-family: helvetica;"><em>A Laboratory Technologist conducting a test at the hospital&#39;s Laboratory facility</em>
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</span></div><div><span style="font-family: helvetica;">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.</span></div><div><br style="font-family: helvetica;"/></div><div><span style="font-family: helvetica;">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.</span></div><div><br style="font-family: helvetica;"/></div><div><span style="font-family: helvetica;">Accreditation verifies the adherence by the laboratories to established quality and competence standards needed for accurate and reliable testing combined with staff safety.</span></div><div><br style="font-family: helvetica;"/></div><div><span style="font-family: helvetica;">In the developed world accreditation is common practice for medical laboratories, but this is not the case where there are only limited resources. A study of sub-Saharan African countries showed that 37 out of 49 had no clinical laboratories accredited to internationally recognized quality standards. </span></div><div><br style="font-family: helvetica;"/></div><div><span style="font-family: helvetica;">Kenya was listed as having eight accredited laboratories including the one at the Aga Khan University Hospital, Nairobi (AKUHN). In 2011, the AKUHN became the first to achieve international accreditation in sub-Saharan Africa outside 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. AKUH, N laboratory has also applied to be evaluated and accredited by the word most respected accreditation body - The College of American Pathologists (CAP). CAP is the leading organization of board-certified pathologists, serves patients, pathologists, and the public by fostering and advocating excellence in the practice of pathology and laboratory medicine worldwide. </span></div><div><br style="font-family: helvetica;"/></div><div><span style="font-family: helvetica;">Unlike other accreditation bodies, CAP has educational materials, proficiency testing programs, online quality improvement tools, multi-site benchmarking and peer comparison studies, tools for continuous quality monitoring of laboratory processes for performance improvement and standards that monitor all the instruments in the laboratory on a routine basis while at the same time augmenting instrument comparability efforts. Once accredited, AKUH, N Laboratory will be part of an exclusive group of more than 6,000 laboratories worldwide that have met CAP&#39;s highest standards of excellence.</span></div><div><br style="font-family: helvetica;"/></div><div><span style="font-family: helvetica;">This demonstrates that the tests carried out in the laboratory are undertaken by competent staff, using qualified equipment, validated methods, and quality supplies within a controlled environment. The tests are right – first time and every time. The measures put in place by implementing accreditation standards and requirements increase confidence that results generated by the hospital’s laboratory are comparable to results generated in other accredited laboratories and the chances of getting wrong results are remote.</span></div><div><br style="font-family: helvetica;"/></div><div><span style="font-family: helvetica;">The AKUHN participates in external quality assessment and uses primary standards to calibrate equipment which ensures that results are traceable to national and international standards. There is an established quality management system which has reduced procedural errors by preventing, ensuring timely detection and action on errors.</span></div><div><br style="font-family: helvetica;"/></div><div><span style="font-family: helvetica;">The accreditation requirement of an effective continuous medical education program helps the laboratory staff keep up-to-date with global professional development and stay on the cutting edge of technology developments in their field. Regular accreditation assessments enhance staff discipline and a sense of professionalism which improves performance.</span></div><div><br style="font-family: helvetica;"/></div><div><span style="font-family: helvetica;">Since becoming a SANAS accredited laboratory, the Kenya Medical Laboratory Technologist and Technician Board (KMLTTB) has recognized AKUHN as a training and reference laboratory to validate new testing equipment and critical supplies prior to being used in Kenya.</span></div><div><br style="font-family: helvetica;"/></div><div><span style="font-family: helvetica;">The information generated by AKUHN laboratory is used by the government and regulators to make decisions related to protecting the health and welfare of consumers and the public, protecting the environment, developing new regulations, national policy documents and requirements. The information is also important in assessing compliance with regulatory and legal requirements. </span></div><div><br style="font-family: helvetica;"/></div><div><em style="font-family: helvetica;">By Mr Edwin Kibet, Administrator, Department of Pathology at Aga Khan University Hospital</em></div>

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