Histology Lab at the Machakos Level 5 County Hospital
This spotlight was hosted by the Referral Laboratory Quality Manager, Brilliant Imungu.
Q: What services do you currently provide in your lab (e.g. histology, special stains, cytology, bone marrows, IHC)?
A: Machakos provides histology, special stains, cytology and bone marrow services. Diagnostic services are rendered in the main laboratory block, and they include chemistry, microbiology, hematology, molecular testing (Tb), blood transfusion, parasitology, immunology and transfusion (blood donation).
Q: What is your current case volume and do you anticipate growth in this volume over the next year? Or next 5 years?
A: Machakos experiences a case volume per month of 130 histology cases, 100 cytology cases, 250 pap smears, and approximately 5 bone marrow cases.
Q: What is the patient population at your hospital?
A: Machakos has a bed occupancy of 506, and serves about 24,000 out-patients and 2,500 in-patients per month. A recent introduction of Universal health Coverage has resulted in an increase of patients beyond the capacity of the hospital.
Q: Who is the lab director and how is the lab organized?
A: We have a laboratory manager who heads laboratory technical staff and reports to the hospital medical superintendent.
Q: How many pathologists do you have on staff?
A: Currently, we have 3 pathologists who are directly answerable to the medical superintendent.
Q: Can you describe your quality management processes?
A: Machakos laboratory has established a quality policy and plan to work towards meeting and sustaining ISO 15189:2012. The laboratory used the World Health Organization Checklist (2015) on strengthening laboratory quality management towards accreditation. We endeavor to improve our quality management processes for other departments, including Histology.
Q: What are your three main challenges?
A:
Implementation of quality systems in histology and cytology, and more so, setting up a competence and proficiency testing program.
Reporting of bone marrow
The number of samples coming in is overwhelming vis-à-vis the number of personnel
Q: What are your biggest success stories?
A:
Previously, patients were waiting for months to be attended to at the National Referral Hospital in Nairobi. Now, the services are nearer and the waiting time has reduced significantly from 2 months to 2-3 weeks.
Outreaches were conducted in several centers within the county (especially for pap smears). We have also established referral systems for the early detection of cancer.
Histology tests are normally quite expensive, but through the Machakos Universal Healthcare Plan, free services are offered to needy patients.
Q: Are you working toward accreditation? If so which accreditation body?
A: So far three departments were accredited by Kenya Accreditation service in September 2019, including microbiology, hematology and chemistry.