Annual audit of haematology tests performed at a laboratory of a tertiary teaching hospital in Dar es salaam Tanzania

Abstract

Background Monitoring of laboratory performance is crucial as it plays a central role in diagnosis, management and clinical decision making. With commencement of haematology clinical and laboratory services at the MUHAS Academic Medical Centre (MAMC); smooth ordering, handling and transfer of specimen and timely return of results can be challenging. We aimed to assess the function and efficacy of haematology clinics and evaluate the capacity of MAMC laboratory in performing tests ordered from the haematology clinics, as established by hospital guidelines. Methodology This was a retrospective descriptive study conducted from 1st of January to 31st March, 2018 in MAMC in Dar es Salaam, Tanzania. The study involved the Haematology and Blood Transfusion outpatient clinic department and laboratory section. Analytical and post-analytical phases of laboratory functions were measured against established standards stipulated under MAMC specialized clinic and laboratory services guidelines. Results A total of 53 patients attended the weekly haematology clinics. None had Haemoglobin (Hb) or Complete Blood Count (CBC) results available before doctor’s consultation. 75 different haematological tests were ordered. 81.3% of orders were collected and only 21.3% of the collected have results available in the Hospital Information System (HIS). Sickle Cell Disease (SCD) tests are not performed at MAMC. Half of the hemoglobin results (Hb) and two-third of the complete blood count results (CBC) were under the Turnaround Time (TAT) from time of sample collection to results, respectively. The number is lower when taken from the time of test order. Conclusion The weekly haematology clinics at MAMC operate below the standards set by the hospital. This is significantly contributed by laboratory performance. The capacity and operation of the MAMC laboratory is still below set standards, both in terms of number of haematological tests it performs and attainment of set TAT. Reporting of results to the HIS is also not fully implemented. Keywords: Audit, Haematology, Sickle Cell Disease, Turnaround Time, Hospital Information System, Outpatient Department, Clinics, Haemoglobin, Complete Blood Count