Management & Operations

Three Lab Site Visits in Saudi Arabia Reveal Much in Common with U.S. Labs

Last week, while in Saudi Arabia to participate in the "Pathology Update 2008-International Symposium on Laboratory Medicine," your Dark Daily editor visited three hospital laboratories in the capital city of Riyadh. There are many similarities between the organization and operation of laboratories in Saudi Arabia those in the United States and the United Kingdom. There is a surprising reason for these similarities, but more on that in a moment.

The first hospital laboratory visited by Dark Daily was at the Riyadh Military Hospital. The hospital was constructed in 1979 and was expanded in several stages to its current size of 1,800 beds. However, as the hospital expanded, the laboratory was not given proportionately more space. It performs more than 12 million tests per year, and does it from inadequate space. All the analyzers and instrument systems are up-to-date technology. Our host and tour guide was Dr. Rofaida M. Dafterdar, MBBS, Dip.P.C., MSc, KSUF (Path),Consultant Chemical Pathologist and Head of Clinical Chemistry Department. A new source of pride is the just-delivered total laboratory automation system (TLA) by Roche Diagnostics. The equipment was uncrated and awaiting installation.

Dr. Dafterdar explained that the Riyadh Military Hospital is funded and operated by the military for the benefit of service personnel and their dependents. The laboratory serves inpatients and provides all outpatient testing for the clinics which are located within the hospital campus. Dr. Dafterdar is keenly interested in introducing Lean and Six Sigma management techniques into her laboratory and is taking the first steps to realize that goal.

Another laboratory on our tour was the National Guard Hospital at King Abdulaziz Medical City . This hospital was built in the mid-1980s and is based on hospital design principles of the United States of that era. That fact is not coincidence. At that time, Hospital Corporation of America  (HCA) helped design, build, and start up the hospital. It then managed the hospital under contract for several more years.

The laboratory is state-of-the-art and recognized as a top lab in Saudi Arabia. It earned its accreditation with the College of American Pathologists (CAP) in the 1980s and has maintained that status continuously. It produces 10 million billable results annually and serves the 1,000-bed hospital and related outpatient clinics. Our host was Muhammad Ashraf Ali, M.D., FCAP, RRCP, Chairman, Department of Pathology and Laboratory Medicine. He holds a notable distinction. He did his medical training in the United States and was the first board-certified pathologist in Saudi Arabia when he returned to his homeland in the mid 1970s. Dr. Ali explained that the Ministry of the National Guard funds this hospital and it provides care to National Guard personnel and their dependents.

Our tour of the laboratory was conducted by Zaid Al-Hazmi, Laboratory Operations Administrator. As we visited each department, we saw latest-technology instrument systems and analyzers. Molecular diagnostics is a rapidly-expanding area of the laboratory and the National Guard Hospital laboratory offers an extensive menu of molecular tests. This laboratory was comparable to most of the better tertiary care and academic center laboratories in the United States.

The newest laboratory we visited was at King Fahd Medical City . An extensive hospital complex of 1,500 beds, including specialty hospital facilities for women's care, cancer, cardiology, and rehabilitation, was constructed in the 1990s. Our host and tour guide was Dr. John Lubega, MCbhB, MSc., Ph.D., LCRP, MRCS, MIBiol, Consultant & Head of Department of Clinical Biochemistry. He told us an interesting story. "King Fahd Medical City was constructed in the 1990s and stood empty and unused for almost 10 years," he explained. "It was about four years ago that the Ministry of Health opened King Fahd Medical City to patients.

Since his arrival at the laboratory about three years ago, Dr. Lubega has developed the high-volume core laboratory with modern instrument systems in a spacious laboratory. "Our hospital only accepts referral patients because it provides specialized care," he noted. "That is one reason why our occupancy ranges between 700 and 800 beds. Thus, our laboratory space is currently underutilized." The facility is an open laboratory design and Dr. Lubega's high volume core lab is extensively automated.

One observation about these three laboratories is that each faces the same shortage in trained technical staff that is common in other developed countries. The vacancy factors can be 10% to 20%. In past years, the nation has recruited foreign nationals to fill these vacancies in the laboratories.

I promised earlier to reveal the unexpected reason why laboratories in Saudi Arabia are organized and operated in vary similar fashion to their counterparts in the United States and the United Kingdom. It is because a significant number of pathologists, clinical chemists, and skilled technical staff did their training in the U.S.A. and the U.K. Upon returning to Saudi Arabia, they incorporated these management systems and operating models into their own laboratories.

Finally, the experience of participating and speaking at the Pathology Symposium was quite energizing. The science of the presentations was at a high level. The sessions were conducted in English and the audience always had lots of questions for each speaker. We were warmly greeted and always met with gracious hospitality at every event and laboratory site visit. To our hosts and new friends in Saudi Arabia and nearby countries, we offer sincere thanks!
 

From the bustling city of Riyadh,

 
Robert Michel
Dark Daily Editor
 

rmichel@darkreport.com