For : Dra.

Potri Disomimba Ali

Subject : Upgrade of Present Clinical Laboratory The existing mandatory requirements of the Department of Health ( DOH ) is the challenge we have to face in establishing the best clinical laboratory of Tamparan Medical Foundation Inc. Our DOH has set various requirements In keeping up with the global trend on quality systems in health care operations. These has resulted to high quality , dependable, reliable results but less affordable cost to majority of the population. To give a clearer picture of compliance to this mandate, we were able to put up the start-off laboratory equipment for the ( primary ? / Secondary ? ) laboratory services which include the following : 1. Hematology using a semi-automated hematology analyzer with ( 19 blood indices as parameters, please check with your unit, how many parameters it can analyze, our unit in the clinic has 21 blood indices as parameters ). Describe briefly the features, how many tests can it do per minute. 2. Chemistry Analyzer which runs a battery of routine blood chemistries, a total of ___ initially, and can still be programmed ( can it? ) for additional tests.

With the above initial equipment, we have started examining 15-20 persons per week and average,5 tests per individual during the first week. A doubling pattern on a weekly basis is expected with the marketing efforts which we have started to plan. The necessary upgrade to tertiary level will require voluminous trainings of staff concerned which includes : 1. HIV Training 2. Drug Analyst Training
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3. Microbiology Training 4. Immunology Training On top of the training for competency and skills of our medical technologist, the waste management program is another concern which should be addressed and a separate training of selected officer in charge shall be undertaken. While we have plans for all the training requirements, the constraints come from the office of the mandate itself, as number of applicants wanting to be trained are limited. Likewise, these trainings are only being held once a year. Since the Laboratory is considered a big department of the Hospital it is expected to have its own organizational structure with quality manuals that present clearly its policies, procedures as well as work instructions for every test which will be performed. The test of implementation of such written quality procedures shall be done at random since our government requires participation in the National External Quality Assurance System ( NEQAS ) of various government hospitals. Membership to this NEQAS for the random testing of any DOH accredited health care facility should be complied with for a fee including the cost of random tests yearly.
The mandated IDTOMIS ( Integrated Drug Testing Operations Management System ) for the drug testing requirement would require a properly trained Team of laboratory staff not limited to the drug analyst.

In consideration of the stringent mandatory requirements, it is prudent to act conservatively in the upgrading plan, and this means to go on a Phase 1 , 2 or even 3 Stages of Development. This would mean that the preparation should include the training or retraining of existing laboratory staff on quality requirements as well as skill and competency for the conduct of serological and special tests. Looking at the whole picture would give us this estimated costing appropriate to the proposed Phasing :
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Phase I A. Training Requirements Training of HIV Personnel and Endorsement to DOH (or refresher course for trained hired personnel ) Drug Analyst Training Microbiology Training Waste and Safety Officer Training Application for Upgrade Total : B. Equipment Upgrade Lifeline / equivalent Equipment for Serology Safety Hood for Microbiology Equipment for Electrolytes and Coagulation Factors Total :

Estimated Cost

35,000.00

10,000.00 15,000.00 20.000. 00 100.000 .00 180,000.- / year

2,800,000 .800,000.490,000.3,090,000 .-

C. Documentation Requirements / Quality System Requirement/ Legal Licensing / legal equirements SOP Manual of Operation , Quality Documentation External Quality Assurance Membership for Testing and Maintenance of Laboratory Operations 185,000.00 155, 000.00 12,000.00 172,000.00 / year

Total :
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PHASE 2 :Quality Certification Requirements ISO or PCAHO ( Philippince Council on Accreditation of Health Care Organizations ) or pcahO Quality certification 150,000 Maintenance of Laboratory Equipment and Year round Servicing 26,000

Remark : I placed the quality certification last, because upon application, a time period is allowed for health facility to operate before DOH requires a quality certification. Also, quality trainings are difficult for some. It is best that you try to extract something from your current statistics and add pictures of laboratory in between for a more interesting presentation. Note Anatomic pathology excluded yet in this proposal. Hoping that this be under Phase 3, continuing improvement of the tertiary laboratory. Should you have any related query, please feel free to contact the undersigned.

Gigi /gpa