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Physicians' satisfaction with clinical laboratory services at public hospitals in Ethiopia: A national survey. PLoS One 2020; 15:e0232178. [PMID: 32353001 PMCID: PMC7192407 DOI: 10.1371/journal.pone.0232178] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 04/09/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction Physician is a central figure in the client list of clinical laboratory. Monitoring physicians’ satisfaction with laboratory service is an important indicator of the quality management system and required by international laboratory standards. However, there is no national data on physician satisfaction with laboratory services in Ethiopia. Therefore, the aim of this national survey was to assess satisfaction level of physicians with laboratory services at public hospitals in Ethiopia. Methods Institutional based cross-sectional study design was employed from November 1-30/2017. A total of 327 physicians were randomly selected from 60 public hospitals from all regions of Ethiopia. Data was collected using pre-tested self-administered questionnaire and analyzed with SPSS version 23 software. Logistic regression model was fitted to identify predictors of physician satisfaction with laboratory services. A p-value of less than 0.05 was taken as statistically significant. Results Overall, 55% of physicians were satisfied with the clinical laboratory services. More than half of the physicians were satisfied with the existing laboratory request form (69%), legibility and completeness of laboratory report (61%), notification of new test (78%) and test interruption (70%). On the other hand, many physicians were dissatisfied with the absence of laboratory hand book (87.5%), the existing test menu (68%), lab-physician interface (62%), availability of referral and/or back up service (62%), notification of Turn Around Time (TAT) (54%), timely notification of panic result (55%), long TAT (33.1%), provision of urgent service (67%), and timely advisory service (57%). Most of the physicians perceived that consistent quality of service was not delivered at all working shifts (71%). At 5% level of significance, we did not find enough evidence to conclude that sex, age, marital status, education level, and experience were statistically associated with physician satisfaction (p-values > 0.05). Conclusion This national survey revealed nearly half of the physicians were unsatisfied with laboratory service at public hospitals in Ethiopia, which mainly related to lack of adequate test menu, laboratory hand book, on time notification of panic result, provision of urgent service, timely advisory service, delivery of quality services in all working shifts and weak lab-physician interface. Therefore, hospital management should address the gaps and improve the needs of physicians for better patient health care. In addition, laboratories should evaluate and monitor physician satisfaction level at regular interval.
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Mesman AW, Bangura M, Kanawa SM, Gassimu JS, Dierberg KL, Sheku MM, Orozco JD, Marsh RH. A comprehensive district-level laboratory intervention after the Ebola epidemic in Sierra Leone. Afr J Lab Med 2019; 8:885. [PMID: 31745458 PMCID: PMC6852544 DOI: 10.4102/ajlm.v8i1.885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 03/18/2019] [Indexed: 01/27/2023] Open
Abstract
Background The 2014–2016 Ebola outbreak exposed the poor laboratory systems in Sierra Leone. Immense needs were recognised across all areas, from facilities, diagnostic capacity, supplies, trained personnel to quality assurance mechanisms. Objective We aimed to describe the first year of a comprehensive intervention, which started in 2015, in a public hospital’s general laboratory serving a population of over 500 000 in a rural district. Methods The intervention focused on (1) supporting local authorities and healthcare workers in policy implementation and developing procedures to enhance access to services, (2) addressing gaps by investing in infrastructure, supplies, and equipment, (3) development of quality assurance mechanisms via mentorship, bench-side training, and the introduction of quality control and information systems. All work was performed alongside counterparts from the Ministry of Health and Sanitation. Results We observed a strong increase in patient visits and inpatient and outpatient testing volumes. Novel techniques and procedures were taken up well by staff, leading to improved and expanded service and safety, laying foundations for further improvements. Conclusion This comprehensive approach was successful and the results suggest an increase in trust from patients and healthcare workers.
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Affiliation(s)
- Annelies W Mesman
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States.,Partners In Health, Boston, Massachusetts, United States
| | - Musa Bangura
- Partners In Health, Boston, Massachusetts, United States
| | - Sahr M Kanawa
- Ministry of Health and Sanitation, Koidu, Sierra Leone
| | | | - Kerry L Dierberg
- Partners In Health, Boston, Massachusetts, United States.,Division of Infectious Diseases and Immunology, New York University, New York, New York, United States
| | | | | | - Regan H Marsh
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States.,Partners In Health, Boston, Massachusetts, United States.,Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States
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Ishengoma DS, Kamugisha ML, Rutta ASM, Kagaruki GB, Kilale AM, Kahwa A, Kamugisha E, Baraka V, Mandara CI, Materu GS, Massaga JJ, Magesa SM, Lemnge MM, Mboera LEG. Performance of health laboratories in provision of HIV diagnostic and supportive services in selected districts of Tanzania. BMC Health Serv Res 2017; 17:70. [PMID: 28114988 PMCID: PMC5259978 DOI: 10.1186/s12913-017-2030-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 01/17/2017] [Indexed: 11/24/2022] Open
Abstract
Background Roll-out and implementation of antiretroviral therapy (ART) necessitated many countries in Sub-Saharan Africa to strengthen their national health laboratory systems (NHLSs) to provide high quality HIV diagnostic and supportive services. This study was conducted to assess the performance of health laboratories in provision of HIV diagnostic and supportive services in eight districts (from four regions of Iringa, Mtwara, Tabora and Tanga), after nine years of implementation of HIV/AIDS care and treatment plan in Tanzania. Methods In this cross-sectional study, checklists and observations were utilized to collect information from health facilities (HFs) with care and treatment centres (CTCs) for HIV/AIDS patients; on availability of laboratories, CTCs, laboratory personnel, equipment and reagents. A checklist was also used to collect information on implementation of quality assurance (QA) systems at all levels of the NHLS in the study areas. Results The four regions had 354 HFs (13 hospitals, 41 Health Centres (HCs) and 300 dispensaries); whereby all hospitals had laboratories and 11 had CTCs while 97.5 and 61.0% of HCs had both laboratories and CTCs, respectively. Of the dispensaries, 36.0 and 15.0% had laboratories and CTCs (mainly in urban areas). Thirty nine HFs (12 hospitals, 21 HCs and six dispensaries) were assessed and 56.4% were located in urban areas. The assessed HFs had 199 laboratory staff of different cadres (laboratory assistants = 35.7%; technicians =32.7%; attendants = 22.6%; and others = 9.1%); with >61% of the staff and 72.3% of the technicians working in urban areas. All laboratories were using rapid diagnostic tests for HIV testing. Over 74% of the laboratories were performing internal quality control and 51.4% were participating in external QA programmes. Regional and district laboratories had all key equipment and harmonization was maintained for Fluorescence-Activated Cell Sorting (FACS) machines. Most of the biochemical (58.0%) and haematological analysers (74.1%) were available in urban areas. Although >81% of the equipment were functional with no mechanical faulty, 62.6% had not been serviced in the past three years. Conclusion Diagnostic and supportive services for HIV were available in most of the HCs and hospitals while few dispensaries were providing the services. Due to limitations such as shortage of staff, serving of equipment and participation in QA programmes, the NHLS should be strengthened to ensure adequate human resource, implementation of QA and sustainable preventive maintenance services of equipment.
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Affiliation(s)
- Deus S Ishengoma
- National Institute for Medical Research, Tanga Research Centre, P. O. Box 5004, Tanga, Tanzania.
| | - Mathias L Kamugisha
- National Institute for Medical Research, Tanga Research Centre, P. O. Box 5004, Tanga, Tanzania
| | - Acleus S M Rutta
- National Institute for Medical Research, Tanga Research Centre, P. O. Box 5004, Tanga, Tanzania
| | - Gibson B Kagaruki
- National Institute for Medical Research, Tukuyu Research Centre, P. O. Box 538, Tukuyu, Tanzania
| | - Andrew M Kilale
- National Institute for Medical Research, Muhimbili Research Centre, P. O. Box 3436, Dar es Salaam, Tanzania
| | - Amos Kahwa
- National Institute for Medical Research, Muhimbili Research Centre, P. O. Box 3436, Dar es Salaam, Tanzania
| | - Erasmus Kamugisha
- Catholic University of Health and Allied Sciences, P. O. Box 1464, Mwanza, Tanzania
| | - Vito Baraka
- National Institute for Medical Research, Tanga Research Centre, P. O. Box 5004, Tanga, Tanzania
| | - Celine I Mandara
- National Institute for Medical Research, Tanga Research Centre, P. O. Box 5004, Tanga, Tanzania
| | - Godlisten S Materu
- National Institute for Medical Research, Tukuyu Research Centre, P. O. Box 538, Tukuyu, Tanzania
| | - Julius J Massaga
- National Institute for Medical Research, P. O. Box 9653, Dar es Salaam, Tanzania
| | - Stephen M Magesa
- National Institute for Medical Research, Amani Research Centre, P. O. Box 81, Muheza, Tanzania
| | - Martha M Lemnge
- National Institute for Medical Research, Tanga Research Centre, P. O. Box 5004, Tanga, Tanzania
| | - Leonard E G Mboera
- National Institute for Medical Research, P. O. Box 9653, Dar es Salaam, Tanzania
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Noble MA, Martin R, Ndihokubwayo JB. Making great strides in medical laboratory quality. Afr J Lab Med 2014; 3:256. [PMID: 29043199 PMCID: PMC5637788 DOI: 10.4102/ajlm.v3i2.256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Michael A Noble
- Program Office for Laboratory Quality Management, University of British Columbia, Canada
| | - Robert Martin
- Department of Global Health, University of Washington, United States
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Addis Z, Birhan W, Derseh D, Sahle B, Gizaw N. Physicians' and nurses' satisfaction with the clinical laboratory service of Gondar University Hospital, northwest Ethiopia. Am J Clin Pathol 2013; 140:324-8. [PMID: 23955450 DOI: 10.1309/ajcpu1plvoin5jqi] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES To assess physicians' and nurses' satisfaction with the service provided by the laboratory at Gondar University Hospital. METHODS We conducted a cross-sectional study involving 196 nurses and physicians. RESULTS Overall level of satisfaction was 51.1% for nurses and 51.5% for physicians. Lack of consistency in the quality of laboratory work, absence of a timely report of critical values, test turnaround time, acceptability of results released, and reporting of reference ranges with test results were areas mentioned as sources of dissatisfaction. CONCLUSIONS The study showed wide room for improvement. In addition to taking intervention, root causes of dissatisfaction need to be investigated and means of improving the satisfaction level should be designed and implemented.
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Affiliation(s)
- Zelalem Addis
- University of Gondar, College of Medicine and Health Sciences, School of Biomedical and Laboratory Sciences, Gondar, Ethiopia
| | - Wubet Birhan
- University of Gondar, College of Medicine and Health Sciences, School of Biomedical and Laboratory Sciences, Gondar, Ethiopia
| | - Dejene Derseh
- University of Gondar, College of Medicine and Health Sciences, School of Biomedical and Laboratory Sciences, Gondar, Ethiopia
| | - Biruktawit Sahle
- University of Gondar, College of Medicine and Health Sciences, School of Biomedical and Laboratory Sciences, Gondar, Ethiopia
| | - Netsanet Gizaw
- University of Gondar, College of Medicine and Health Sciences, School of Biomedical and Laboratory Sciences, Gondar, Ethiopia
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Teklemariam Z, Mekonnen A, Kedir H, Kabew G. Clients and clinician satisfaction with laboratory services at selected government hospitals in eastern Ethiopia. BMC Res Notes 2013; 6:15. [PMID: 23324260 PMCID: PMC3556148 DOI: 10.1186/1756-0500-6-15] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 01/14/2013] [Indexed: 11/13/2022] Open
Abstract
Background In clinical laboratory service, patients and clinical service providers are the primary focus of survey of satisfaction in many countries. The objective of the study was to assess clients’ and clinicians’ satisfaction with laboratory services at selected government hospitals in eastern Ethiopia from May to June, 2010. Findings A cross sectional study was conducted at Dil Chora, Jugal, Hiwot Fana and Bisidimo hospitals. Data were collected from 429 patients and 54 clinical service providers. A statistical analysis was conducted using Likert Scale and SPSS Version 16 software. Most of the patients (87.6%) were satisfied with the laboratory services. The lowest [2.48 ± 1.39] and highest [4.27 ± 0.83] rate satisfaction were on cleanness of latrine to collect specimens and availability of laboratory staff on working hours respectively. The extent of the patients’ satisfaction was different among the study hospitals (P-value < 0.05). Most of the clinical services providers (80%) were also satisfied with the laboratory services. The lowest [3.02 ± 1.36] and highest [3.78 ± 1.03] rate of satisfaction were found on critical value notification and timely test results for HIV/AIDS patients care respectively. Conclusion The overall degree of customers’ satisfaction with laboratory services was high. But there were some services such as the cleanness of latrines, information given during specimen collection outside laboratory and critical value notification which need attention. Therefore, the hospital administrations and the laboratory departments should work harder and closely to solve the identified problems. Further study with a larger sample size and more factors is recommended.
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Affiliation(s)
- Zelalem Teklemariam
- Department of Medical Laboratory Sciences, Haramaya University, College of Health and Medical Sciences, Dire Dawa, Ethiopia.
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Mindaye T, Taye B. Patients satisfaction with laboratory services at antiretroviral therapy clinics in public hospitals, Addis Ababa, Ethiopia. BMC Res Notes 2012; 5:184. [PMID: 22520145 PMCID: PMC3392742 DOI: 10.1186/1756-0500-5-184] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Accepted: 04/20/2012] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Despite the fact that Ethiopia has scale up antiretroviral treatment (ART) program, little is known about the patient satisfaction with ART monitoring laboratory services in health facilities. We therefore aimed to assess patient satisfaction with laboratory services at ART clinics in public hospitals. METHODS Hospital based, descriptive cross sectional study was conducted from October to November 2010 among clients attending in nine public hospitals ART clinics in Addis Ababa Ethiopia. Patients' satisfaction towards laboratory services was assessed using exit interview structured questionnaire. Data were coded and entered using EPI info 2002 (Centers for Disease Control and Prevention Atlanta, GA) and analyzed using SPSS version 15 software (SPSS INC, Chicago, IL, USA). RESULTS A total of 406 clients were involved in the study. Of these 255(62.8%) were females. The overall satisfaction rate for ART monitoring laboratory services was (85.5%). Patients were satisfied with measures taken by health care providers to keep confidentiality and ability of the person drawing blood to answer question (98.3% and 96.3% respectively). Moreover, the finding of this study revealed, statistical significant associations between the overall patients' satisfaction with waiting time to get blood drawing service, availability of ordered laboratory tests and waiting time to get laboratory result with (p < 0.05). Patients receiving blood drawing service less than 30 minute were 7.59 times (95% CI AOR: 3.92-14.70) to be more satisfied with ART monitoring laboratory services compared to those who underwent for more than 30 minutes. CONCLUSIONS Overall, the satisfaction survey showed, most respondents were satisfied with ART monitoring laboratory services. However, factors such as improving accessibility and availability of latrines should be taken into consideration in order to improve the overall satisfaction.
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Affiliation(s)
- Tedla Mindaye
- College of Health Science, School of Clinical laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Bineyam Taye
- College of Health Science, School of Clinical laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
- College of Health Science, School of public health, Addis Ababa University, Addis Ababa, Ethiopia
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Etienne M, Hossain M, Redfield R, Stafford K, Amoroso A. Indicators of Adherence to Antiretroviral Therapy Treatment Among HIV/AIDS Patients in 5 African Countries. ACTA ACUST UNITED AC 2010; 9:98-103. [DOI: 10.1177/1545109710361383] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As the HIV epidemic threatens the social fabric of countries struggling with HIV prevalence rates as high as 10% to 30%, access to antiretroviral therapy (ART) alone is only the beginning of the clinical challenge. There is a need to identify adherence indicators that will ensure long-term treatment success. A cross-sectional review of 921 adult patients on ART for at least 1 year was conducted. Through an administered adherence survey, key indicators were found to be highly correlated with patient adherence. The adherence rate in this sample was 72% after being on treatment for an average of 15 months. This data suggest that having a high perceived quality of care and owning one’s own home positively affected patients’ adherence. Indicators such as alcohol use in the last month and a high level of depression negatively affected patients’ adherence. Targeting specific indicators for specific interventions will guard against nonadherence, leading to treatment failure.
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Affiliation(s)
- Martine Etienne
- Institute of Human Virology of the University of Maryland School of Medicine, Baltimore, MD, USA,
| | - Mian Hossain
- Morgan State University School of Community Health and Policy, Baltimore, MD, USA
| | - Robert Redfield
- Institute of Human Virology of the University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kristen Stafford
- Institute of Human Virology of the University of Maryland School of Medicine, Baltimore, MD, USA
| | - Anthony Amoroso
- Institute of Human Virology of the University of Maryland School of Medicine, Baltimore, MD, USA
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