Improving Report Generation and Delivery System of Microbiological Investigations at MRI – Sri Lanka with Concern to Turn-Around-Time, An Intervention Study

Pamila Adikari,Lilani Karunanayake,Sunil De Alwis

doi:10.3991/ijoe.v16i09.13799

Abstract

Background: Clinical Bacteriology Laboratory (CBL) of the Medical Research Institute (MRI) is a National Reference Laboratory in Sri Lanka. The service improvement research project aimed at improving the report generation and delivery system. Methods: The mixed-method applied to study the process. Gap identification and designing of the intervention used a qualitative approach. Quantitative methods measured the effectiveness of the improvements. A package of interventions based on total quality management (TQM) principles designed with all stakeholder participation. Results: Delay in sample transport resulted from poor communication, lack of established mechanism and weak coordination between the transport unit and wards. The paper-based report generation process was disorganized, unreliable and error-prone. Additionally, the report delivery to Hospitals revolved on the incoming ambulance or government postal service a tied-up, poorly coordinated system. The interventions promoted coordinated communication. WHONET, a free windows based Laboratory Information System and database software, developed by the World Health Organization for microbiology laboratories installed to generate reliable and accurate automated reports. Reports in PDF format delivered to end-users by secured email. Timeliness, accuracy, quality and uniformity of reports improved. Improvement in post-intervention turn-around-time was statistically significant (p&lt;0.05). Conclusion: The interventions based on TQM principles improved the process of report generation and delivery. Laboratory automation is a feasible and effective solution in the local setting. The end-user satisfaction perceived to be high on the improvements.

Highlights

The Medical Research Institute (MRI) is the foremost reference laboratory in Sri Lanka and provides microbiological services to all hospitals in the country with the highest precision and quickest turnaround times (TAT)
The clinical bacteriology laboratory (CBL) of MRI equipped with state-of-the-art modern equipment to provide clinicians with accurate reports
Poor coordination between the transport department (TD) and wards with weak documentation were the main problems identified in the pre-analytical phase

Summary

Introduction

Sample reception and report delivery process include the collection of the sample at the ward to the delivery of the report to the same. At the ward samples are collected, details are entered in the sample register and sent to the hospital lab for transfer to MRI. At the hospital laboratory sample receipt and transfer are entered in their sample register. The samples are transported by ambulance on routine visits to Colombo They are handed over by the ambulance helpers to the receiving counter at MRI. The Medical Laboratory Technologist (MLT) at the counter enters the details of the samples in their specimen register. The reports are entered in the report receipt register at the counter Either they are handed over to the ambulance or sent via post.

Objectives

Results

Discussion

Conclusion