Vietnam laboratories achieve quality standard
Hue Central Hospital in central Vietnam has a busy microbiology laboratory. A 2,000-bed facility, it receives between 100 to 150 specimens and runs as many as 400 tests daily.
The National Laboratory Capacity Building Program (NLCBP) has enabled the Hue laboratory to better manage its high volume. Hue is now one of only 22 Vietnamese institutions, among hundreds nationwide, to receive International Organization for Standardization (ISO) 15189 accreditation. Funded by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) and implemented by the U.S. Centers for Disease Control and Prevention and FHI 360, NLCBP improves laboratories of key government-run health facilities. These mostly central and provincial hospitals provide services for lower-level facilities that do not have adequate capacity to do their own tests.
Five laboratories similar to Hue underwent more than a year of technical assistance with FHI 360 experts — including new record-keeping systems, equipment maintenance and staff training — but these changes go beyond the individual facility and help the national health system widen its reach. For example, accreditation enhanced the ability of the Ho Chi Minh City's Preventive Medicine Center microbiology laboratory to test samples from more than 100 different clinics and health centers.
This generation of laboratories will also bolster Vietnam's national surveillance and treatment of communicable diseases, particularly tuberculosis (TB). Another recently accredited laboratory at Pham Ngoc Thach Hospital examines more than 23,000 sputum smears a month, mostly from the country's southern provinces, to detect the bacterium that causes TB. As the National Lung Hospital microbiology laboratory in Hanoi prepares for accreditation, it sees patients with respiratory illnesses, has a TB ward, and is a national TB reference laboratory, which oversees the work of 35 northern and provincial laboratories.
Dao Duc Giang, assistant director of clinical research and special projects at the FHI 360 office in Vietnam, said that ISO accreditation is changing how Vietnamese laboratories work.
"Five years ago, the concept of ISO accreditation for medical laboratories was quite new, and even now it is not mandatory to apply for or obtain accreditation in Vietnam. Without the emphasis on managing quality, test results were not consistent and accurate between hospitals."
As a result of the accreditation process at Hue, laboratory results are now more reliable, communication between clinicians and laboratory staff has increased and turnaround times are faster. All these changes benefit both the patients and public health. Maintaining quality testing procedures decreases the number of false-negative results (when a test incorrectly suggests that a person does not have a condition) and false positives (during which a person receives confirmation of an illness they do not actually have). For individual patients and their health care providers, a technically competent laboratory can provide accurate information for patient care and treatment plans. At the facility level, getting tests right the first time eliminates the need for expensive repeat testing.
Dr. Pham Thu Hang, acting manager of Pham Ngoc Thach's laboratory, said that the ISO 15189 certificate is a badge of achievement that symbolizes more than a year of hard work.
"We were very lucky to [have our microbiology laboratory] selected to participate in the NCBLP. Before, we thought the ISO 15189 standard was out of our reach. But by adopting these quality requirements, our laboratory services have been improved, and every laboratory worker feels more responsibility and more connection with the laboratory work."