Pontificia Universidad Católica Chile

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1 Pontificia Universidad Católica Chile Dr Rodríguez, Health Services Director Innovation and investment: Key ingredients for high quality diagnostic services

2 Reaching and maintaining internationally recognized standards for quality and competence is not simply a box-ticking exercise: it requires a constant commitment to excellence and innovation. The six-member laboratory group of the P. Universidad Católica de Chile in Santiago have proved that such a commitment brings real rewards and it enables them to attract sustained investment in the competitive environment for healthcare provision in Chile.

3 Health Services, Pontificia Universidad Católica de Chile Private laboratory services 550 beds 1.8 million Clinical Chemistry results per year 200,000 Immunochemistry results per year

4 Private healthcare provision no room for complacency The sophisticated health insurance system that exists in Chile means that there are many suppliers offering healthcare provision and so patients are able to seek out and select their provider based on quality and service. Dr Rodríguez is keenly aware of this and that s why he focuses on investment in technology and constantly appraises the professionalism of the whole organization. We believe that among all the private laboratory services in Chile, our University has the strongest reputation and that has not come about by chance. Our aim is simply to be the best, which means that everything we do must be able to withstand the most intense scrutiny: internally from our peers, but more importantly externally, from patients, local communities and even government. The Health Services of P. Universidad Católica de Chile comprise three clinics, six laboratories and 13 drawing points, so it s a tough task to ensure that every time a patient has to call on their services, they are left with a feeling that they have been in the best hands. Perhaps nowhere typifies this more than the emergency lab in the Hospital Clinico in Santiago.

5 Our aim is simply to be the best, which means that everything we do must be able to withstand the most intense scrutiny

6 Accurate, timely responses key deliverables in an emergency lab The emergency lab is a very demanding environment, where over 60,000 clinical chemistry and immunochemistry tests are conducted every month, but where the unexpected happens all the time. Response times are extremely strict and highly regulated for instance electrolytes need to be reported in under 30 minutes and prioritization is crucial to maintain workflow through the lab. Edison López and Ricardo de la Barra, medical technologists in the emergency lab, recognize that Roche and cobas 4000 analyzer series have been a big help in maintaining their output. The lab has a mix of analyzers, among which there are two cobas c 311 analyzers and one cobas e 411 analyzer which runs NT-proBNP and other cardiac parameters such as troponin T. They have also installed a cobas b 121 POC system from Roche for blood gas analysis, which they find delivers extremely good performance. Because it s principally, although not exclusively, an emergency lab, we are under great pressure to turn around tests in rapid time, so we really need to be able to depend on our analyzers, not just in terms of coping with the workload, but also in their accuracy. Trust in the results has another level of meaning for the team in the emergency lab because of the types of patient samples they encounter compared with the central laboratory and also the importance to doctors of knowing the results quickly. As Edison López explains: In the emergency setting, where the complexity of diagnosis can demand the testing of a lot of parameters, sensitivity is critical and the cobas parameters for NT-proBNP and troponin T for example, are recognized as the best available. This has real medical value because it allows doctors to rule in or rule out with certainty and to initiate appropriate therapy as soon as possible. So the reliability of our results is paramount and it puts a lot of pressure on us and our systems.

7 We are under great pressure to turn around tests in rapid time, so we really need to be able to depend on our analyzers, not just in terms of coping with the workload, but also in their accuracy.

8 Key Performance Indicators helping to keep output and quality on track In 2005, Dr Rodríguez and his team decided to consolidate their position as one of Chile s leading laboratories by aiming to become the first in the country to be accredited. We knew that accreditation was critical because it would enable us to become a reference lab and as such, allow us to participate in nationally and internationally recognized pathology studies and protocols. To an outsider, such as the patient, this is an absolute measure of quality and gives them confidence that they are undergoing treatment at one of the very best centers. But achieving accreditation is not easy and nothing can be left to chance throughout the whole process and beyond. The implementation plan was very rigorous and involved a step change in the management and training systems in their laboratory group. Quality control managers were appointed, training manuals and comprehensive service and instrument documentation written and physical spaces refurbished. The end result is something that everyone in the team is extremely proud of: a laboratory group that runs efficiently, establishing quality standards that are the envy of other institutions. To me, the greatest benefit of gaining accreditation was one that none of us had foreseen: by doing the basics so efficiently we can start to concentrate on preventing mistakes rather than reacting to them after they ve happened. Because we can now track everything as it goes through our systems, we know exactly where potential errors could be made so we can adjust our procedures accordingly. There are several KPIs that Dr Rodríguez ensures, laboratories in his University Hospital group are committed to achieving. The result of this vigilance can be seen in an obvious way, in that it has enabled continuous compliance with the benchmarks that helped them to gain accredited status in 2006 and ensures that the laboratories continue to perform at a high level. In fact, the performance of cobas 4000 analyzer series and other Roche instrumentation has allowed them to pass successive audits with extra marks.

9 The greatest benefit of gaining accreditation was that by doing the basics so efficiently we can start to concentrate on preventing mistakes rather than reacting to them

10 Accreditation experience why Roche is a key partner The Laboratory Managers Edison López and Ricardo de la Barra both acknowledge that a real testament to the team s performance in gaining accreditation was that a crucial part of their operation the emergency lab was able to cope with the demanding changes required without interruption to their services. The knowledge that Roche has been and continues to be a key partner in this process for many labs in a similar situation was particularly valuable reassurance. With this experience, Roche was able to support the relevant teams throughout the process and assisted with planning and documentation. Without doubt, it also helped to know that cobas analyzers can demonstrate best-in-class performance across a wide range of diagnostic tools and parameters, many of them designed for the routine output of the emergency lab. Our laboratory group has been through a great deal of change in recent years and the whole team feels a great sense of satisfaction in what we have achieved. There is also genuine pleasure in knowing that throughout it all, we have forged a strong relationship with many of our providers, none more so than Roche. We look forward to seeing what we can achieve together in the years to come.

11 Pontificia Universidad Católica Chile

12 COBAS, COBAS B, COBAS C, COBAS E and LIFE NEEDS ANSWERS are trademarks of Roche Roche 1111 Roche Diagnostics Ltd. CH-6343 Rotkreuz Switzerland