Leading specialist Laboratory Service Health Department in Astana Zh . Suleimenova

1. Centralization is the basis for laboratory service reformation in AstanaEXPERIENCE and PERSPECTIVES Leading specialist Laboratory Service Health Department in Astana Zh. Suleimenova

2. GLOSSARY CENTRALIZATION IS A WAY OF ORGANIZING ONE OF MEDICAL SERVICES (LABORATORY SERVICE) ACCORDING TO PLACE IN ORDER TO DECREASE COSTS RELATED TO INCREASED VOLUME OF PRODUCTIVITY. A.A. KISHKUN – “NATIONAL DAYS OF LABORATORY MEDICINE” MOSCOW (RUSSIA) 24TH SEPTEMBER 2015

3. International experience and tendencies in laboratory service market Centralization of laboratory research automatization of producing laboratory research – in developed countries – England, France, Germany, Italy, Japan Total quality management – Introduction of quality management system based on international experience ISO 15189 – 2012 Ensuring biological safety – WHO, CDC recommendations

4. Laboratory service reformation program in Astana 1 step – Centralization on ambulatory-polyclinic level – 2011 2 step– Centralization of laboratories on hospital level - 2016

5. Centralization on ambulatory-polyclinic level #4 City polyclinic ГП – 10 ЦПМСП – 6 Blood chemistry– 40 Immunochemistry- 82 PCR- 6

6. HISTORY #4 City polyclinic

7. International external research quality assessment Quality certificates: general clinical, hematological, biochemical, immunoenzymaticand PCR research. Based on external quality assessment conducted by the USA, the UK, France, Republic Kazakhstan among the best 4 laboratories

8. Laboratory service development perspectives in Astana Optimization clinical-diagnostic laboratories in hospitals and ambulatory medical organizations – maximum service centralization. • Introduction of centralized quality management system in laboratory research and performance indicators assessment system in laboratory service Standardization and implementation of advanced technological methods in laboratory diagnostics, laboratory research succession planning Improvement of human resources via professional staff training at work Creating unified price space for out-of-pocket paid laboratory analysis in net of medical organizations Health department in Astana

9. Centralized laboratory testing quality assurance governanceLaboratory technologies center Organizing performance indicators assessment system based on key performance indicators(KPI) within jurisdictional and subcontractedclinical-diagnostic laboratories in medical organizations in Astana Implementation of external quality control program through inter-laboratory comparison Organizing and conducting expert testing in complicated cases Creating unified database for laboratory data

10. Implementation of Targeted quality assurance indicators in laboratory diagnostics Intra-laboratory control Matching controlreproducibility and accuracy

11. IMPLEMENTATION STEPS 2015 Preparation of regulation (normative) documents Development of centralized governance system МЛ Unified tariff approval Openningbiosample collection places in medical organizations in Astana Accreditation of Centralized laboratory Expert laboratory 3 level Centralized МЛ 2 level 2016 Centralization of laboratory services in medical organizations according to specialization Opening Centralized laboratory’s branches in medical organizations Creating specialized laboratory net in specialized medical centers Specialized МЛ 1 level Biosample collection places withИМЛ