"In this present time of evidence-based medicines, more and more dependence on the laboratory is evident. For all types of diseases, ranging from degenerative to infectious to metabolic to neo-plastic, the laboratory provides the appropriate answer. Laboratory medicine is no longer a backstage tool, but a forefront pointer," he said.
According to the minister, recent events like bio-terrorism and emerging infectious diseases in our region during the past 10 years have challenged both our medical care and public health systems, including our laboratories.
"There are instances where the laboratory systems have been completely overwhelmed. These challenges have made it clear that laboratories - both those of public health and clinical laboratories - need to have well-established relationships and processes to ensure rapid detection, as well as to provide timely and accurate information," he said.
"Clinical laboratories have undergone major changes due to technological progress and economic pressure. While costs of laboratory testing continue to be the dominant issue within the healthcare service worldwide, quality, effectiveness and impact on outcomes are also emerging as critical value-added features."
"In a typical hospital clinical laboratory, thousands of specimens are received and analysed daily. These specimens require correct identification of the patient from phlebotomy through reporting of results to the requesting healthcare provider.
"The increase in the number of tests is also seen in Brunei, where in the past five years, the workload of the laboratory services carried out by our Department of Laboratory Services has increased by 75 per cent to nearly 3.5 million tests in 2007."
He stated that with anatomic and clinical pathology laboratories directly affecting the vast majority of all medical diagnoses, it cannot be denied that laboratory personnel and the work that they perform play a crucial role in protecting and preserving the safety of patients.
A report by the National Patient Safety Foundation in the USA estimated over 100 million Americans are being affected by medical mistakes at a cost of US$200 billion a year. Thus, patient's safety and quality issues need to be addressed system-wide.
According to him, since the Institute of Medicine (IOM) released its report "To Err Is Human: Building a Safer Health System" in 1999, many of the wide-ranging causes of medical error have been identified.
"Most incidents are preventable, and most have little to do with the work done in the laboratory. However, because of the importance placed on accurate test results, those who work in the laboratory hear the ultimate responsibility for patient safety and should therefore follow established best practices," he said.
He further stated that erroneous test results causes by personnel error can lead to improper diagnoses and treatment, which may ultimately cause injury or death.
Laboratory employees should report all medical errors as through the practice of reporting and tracking errors, laboratories become more knowledgeable about where errors are occurring and can work with laboratory personnel to rectify these situations.
"Laboratories need to continue to improve quality and safety by focusing on control of the analytic phase. Laboratory professionals must be leaders in ensuring patient safety both within, and outside of, the walls of the laboratory. This leadership in the medical community begins with developing a culture within the laboratory that empowers laboratory employees to report errors in their own areas," he added.
"Other initiatives, that can reduce errors in laboratory include minimum standards for clinical laboratory testing and these standards include quality control, quality assurance, personnel standards and proficiency testing. Without proper laboratorial training, the likelihood of erroneous laboratory test results increases substantially.
"With medical diagnosis highly dependent on laboratory test results, erroneous test results can have an impact on patient care. Therefore, laboratory organisations should provide mechanisms to improve personnel standards, including certification, maintenance of certification, continuing education programmes for pathologists and laboratory professionals, as well as support of licensure of laboratory personnel."
The minister also believes that the mentoring of junior members of the laboratory is part of their training, and that education continually evolves and therefore accents the need for continual mentoring and guidance.
He raised a number of questions: How will clinical laboratories survive the inevitable changes on the horizon? How will the profession of medical technology and clinical laboratory science evolve? How will new graduate medical technologists learn to adapt to a work environment that is rapidly changing?
"No one can predict with certainty what the laboratory of the future will be like, but it is clear that out of the current chaotic healthcare environment, change will emerge as a constant."
To conclude his speech, the minister left those present with a thought: "As most healthcare changes are dollar-driven, the funding for laboratory employee development programmes, such as continuing education, is dissipating, as is funding for medical technology education in general.
"Because of such cost constraints, the pressing question is, how can we foster motivation and dedication among laboratory personnel in the future?"
Source from : Brunei Online
The Head Department of Medical Laboratory Technology from Kuala Lumpur Metropolitan University College also attended the conference. He is one of the council members of Malaysian Institute of Medical Laboratory Sciences (MIMLS) and also a former president of MIMLS