LAB RATS - Jamaicans’ health at risk as only 5 of 100+ testing labs accredited
Increasing reports of adverse test results have sparked alarm from the watchdog of Jamaica’s medical laboratories, with growing concern over a ballooning crisis as only five of more than a hundred lab companies are accredited to practise.
Though not citing data on the number of retests that have had to be performed because of conflicting or suspect results, the Jamaica National Agency for Accreditation (JANAAC) told The Sunday Gleaner that there is sufficient anecdotal evidence that patients’ health could be at risk from subpar testing regimes.
“We have had issues where persons have complained to us about HIV testing. We have had issues about persons’ simple blood tests. Say, for example, you are doing STD (sexually transmitted disease) testing, we have had persons complain about bad results and you know how these tests have stigma associated with them, so getting it wrong can cause serious relational damage and we have had these issues.
“We also have had issues with other tests, like blood sugar test levels, microbiological test results complaints from persons, because they have not been using accredited labs,” said chief executive officer of JANAAC, Sharonmae Shirley.
The five accredited laboratories in Jamaica are the National Public Health Lab (NPHL), University of the West Indies Microbiology Laboratory, University of the West Indies Department of Pathology, Microlabs, and Biomedical Caledonia Lab.
While accreditation is encouraged, it is not mandatory in Jamaica. The Health Facilities (Medical Laboratories) Act of 2005, which would mandate accreditation, is yet to be passed into law.
“I’m not sure what the hold-up is, but all I would encourage is that we should get it done as soon as possible. However, we (JANAAC) have been encouraging medical laboratories to become accredited, because it’s a good business decision, as well as it provides their customers with the level of confidence in the results that the accredited lab provides,” said Shirley.
The JANAAC boss said that rising queries about test results and the mushrooming of medical labs across Jamaica have prompted the oversight body to run an advertisement campaign urging people to only use accredited labs.
“The lab is not accredited, [so] you are running the risk of using expired chemicals, you run the risk of using equipment that is not calibrated, you run the risk of the test being performed in an environment that is prone to cross-contamination, you run the risk of using staff that are not deemed competent.
“For the accredited labs, we are not saying it is 100 per cent foolproof, but the confidence that you have in using an accredited lab to do your medical testing is far superior to what you would have if you go to a lab that is not accredited. This is why we are so serious now; we want persons to understand that it is critical to their health,” said Shirley.
JANAAC said it has been receiving mounting complaints at its sensitisation campaign sessions.
“So we have been taking it to another level, and they are not just come to us with the issues of the laboratory, but they have come to us with the issues relating to the diagnostic facilities like the MRIs and X-rays, and that is another area that we will begin to be pressing these entities to become accredited,” said Shirley.
JANAAC is the only accreditation body in the English-speaking Caribbean delivering internationally recognised accreditation services and training to laboratories, and inspection and certification bodies. It has accredited medical labs in Guyana, Barbados, Trinidad, and the Bahamas, said Shirley, citing that accreditation is mandatory in the Bahamas.
“An accredited lab goes through a rigorous process of evaluation, so we do not just assess their management systems and the conformance to the international standards, but we also assess the competence of the staff that is employed,” said Shirley.
“What this does is that because the labs must meet these competence criteria at their initial assessment and on an ongoing basis, each year we perform a surveillance – we call it interim assessment – where we visit the lab and we assess a portion of their scope that has been accredited. We keep the accredited labs on their toes,” said Shirley.
Senior lecturer at The University of the West Indies and consultant with the Department of Pathology, Dr Donovan McGrowder, agrees that accreditation of medical labs is critical. He said the issue of conflicting test results is an open secret, and he is urging all laboratories get on board.
“One of the first questions that come up, for example, for clinical trials, is, is your lab accredited? So we applied for accreditation because that’s a requirement from our international partners. We have to meet the standard, the ISO 15189.
“Secondly, we are the main service laboratory to UHWI (University Hospital of the West Indies), so for testing purposes, you really have to meet the international standard, so it was critical for us to be accredited,”said McGrowder.
McGrowder said that private labs, especially, from a business perspective, have an obligation to inspire confidence among clients in their results.
“It is critical for them in terms of the services they offer to their customers, but also in terms of profit, because if a private lab is accredited, it is more likely that the doctors will trust that laboratory and will send their patients to that laboratory, and so they will get more business when compared to others,” said McGrowder.