1. Laboratory Service Health Department in Astana
Centralization is the basis for laboratory service reformation in Astana EXPERIENCE and PERSPECTIVES
Leading specialist
Laboratory Service Health Department in Astana
Zh. Suleimenova

2. GLOSSARY
CENTRALIZATION IS A WAY OF ORGANIZING ONE OF MEDICAL SERVICES (LABORATORY SERVICE) ACCORDING TO PLACE IN ORDER TO DECREASE COSTS RELATED TO INCREASED VOLUME OF PRODUCTIVITY. A.A. KISHKUN – “NATIONAL DAYS OF LABORATORY MEDICINE” MOSCOW (RUSSIA) 24TH SEPTEMBER 2015

3. International experience and tendencies in laboratory service market
Centralization of laboratory research
automatization of producing laboratory research – in developed countries – England, France, Germany, Italy, Japan
Total quality management – Introduction of quality management system based on international experience ISO – 2012
Ensuring biological safety – WHO, CDC recommendations

4. Laboratory service reformation program in Astana
1 step – Centralization on ambulatory-polyclinic level – 2011
2 step – Centralization of laboratories on hospital level

5. Centralization on ambulatory-polyclinic level #4 City polyclinic
ГП – 10
ЦПМСП – 6
Blood chemistry – 40
Immunochemistry - 82
PCR - 6

6. HISTORY Opening of the Center of laboratory technologies
#4 City polyclinic
Opening of the Center of laboratory technologies
Creating laboratory doctors society
Creating clinical basis for JSC “Medical university Astana”
2013 – 2014
Republican conference “Medical laboratory management”
Certification for ISO standard
2015
Participation in the international assessing expert group CLSI in support of Center for Disease Control and Prevention in Central Asia CDC (USA)

7. International external research quality assessment
Quality certificates: general clinical, hematological, biochemical, immunoenzymatic and PCR research.
Based on external quality assessment conducted by the USA, the UK, France, Republic Kazakhstan among the best 4 laboratories

8. Laboratory service development perspectives in Astana
Optimization clinical-diagnostic laboratories in hospitals and ambulatory medical organizations – maximum service centralization.
Introduction of centralized quality management system in laboratory research and performance indicators assessment system in laboratory service
Standardization and implementation of advanced technological methods in laboratory diagnostics, laboratory research succession planning
Improvement of human resources via professional staff training at work
Creating unified price space for out-of-pocket paid laboratory analysis in net of medical organizations Health department in Astana

9. Centralized laboratory testing quality assurance governance Laboratory technologies center
Organizing performance indicators assessment system based on key performance indicators (KPI) within jurisdictional and subcontracted clinical-diagnostic laboratories in medical organizations in Astana
Implementation of external quality control program through inter-laboratory comparison
Organizing and conducting expert testing in complicated cases
Creating unified database for laboratory data

10. Intra-laboratory control POST-ANALYTICAL STAGE
Implementation of Targeted quality assurance indicators in laboratory diagnostics
Intra-laboratory control
Matching control reproducibility and accuracy
PRE-ANALYTICAL STAGE
Errors in identification
0,1%
Number of unusable samples for testing, transportation and storage
Hemolyzed samples
0,06%
ANALYTICAL STAGE
Intra-laboratory quality control coverage
95%
Number of tests with unacceptable results according to variation coefficient
7 %
External quality assessment coverage
75%
POST-ANALYTICAL STAGE
Inappropriate ТАТ
Critical data message
99,9%
Creatinine
3,15
Glucose
3,7
Urea
4,2
Erythrocyte
0,93
Leucocyte
1,97

11. Biosample collection places with ИМЛ
IMPLEMENTATION STEPS
2015
Preparation of regulation (normative) documents
Development of centralized governance system МЛ
Unified tariff approval
Openning biosample collection places in medical organizations in Astana
Accreditation of Centralized laboratory
Expert laboratory
3 level
Centralized МЛ
2 level
2016
Centralization of laboratory services in medical organizations according to specialization
Opening Centralized laboratory’s branches in medical organizations
Creating specialized laboratory net in specialized medical centers
Specialized МЛ
1 level
Biosample collection places with ИМЛ