Quality assurance in clinical laboratory and Types

Concepts of Quality in Health Care

Quality of care

Quality is a way to describe a product or service according to set standard, specifications or expectations. The notion of “high quality” has been associated with terms such as excellence, superiority, high caliber, value and worth. Quality is a complex and multidimensional concept and therefore has been defined in many ways, using different terms, labels and models; the choice of which definition depends on intended use. Quality is also subjective, meaning that it is opinion-based and therefore means different things to different people.

“Quality of care is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge”

Quality of care denotes a degree of performance in relation to a defined standard of interventions known to be safe and have the capacity to improve health within available resources. It denotes accessible and effective care delivered in compliance with evidence-based standards that meet clients’ needs. An example is upon early diagnosis of HIV infection in pregnancy, ART is initiated which leads to HIV-negative children.


In simple terms, quality of care is

  • Doing the right things (what)-applying correct interventions to meet customer needs
  • To the right people (to whom)
  • At the right time (when) and
  • Doing things right first time applying correct processes, efficiently and on time (using set standard).

The concept of right things right as regards to quality of care can be elaborated using an example of laboratory services in a health facility:

Right thing right: Collect blood sample appropriately, put in the right container, label it correctly and submit to lab on time. The lab test will be conducted correctly and as requested, and the results sent to clinic on time.

Right things wrong: Collect blood sample appropriately, put it in the right container, label it correctly, but left it on the table till next day. Fill out correct form, but provide inaccurate information.

Wrong things right: Conduct wrong laboratory test, but conduct it correctly. Fill out incorrect form, but provide accurate information.

Wrong things wrong: Conduct wrong laboratory test, and conducted it incorrectly. Filled out incorrect form, and provided inaccurate information.

Standard and guidelines

Quality of health care is also associated with; compliance with the current GUIDELINES and achieving set STANDARD of care.

Guide lines: Guidelines are detailed collection of policies or procedures by which to determine a course of action or service provision. They provide guidance in setting standards, and act as a set of rules or principles that provide guidance for appropriate conduct. In health care, guidelines refer to a recommended practice in health care provision in order to obtain the expected results.

Standards: A standard care is a formal diagnostic and treatment process a healthcare provider will follow for a patient with a certain symptoms or a specific illness. That standard will follow guidelines and protocols that experts would agree with as most appropriate, also called “best practice.” Standard also refer to a statement of “desired” and “achievable” performance of health care intervention which serves as reference point for evaluation.

  • A standard is defined as an explicit predetermined expectation set by a competent authority that describes an organization’s acceptable performance level. (An implicit standard can be described as a practice that is simply “understood.”).
  • Standard is an agreed-upon, repeatable way of doing something through a set of technical specification or other precise criteria designed to be used consistently as a rule, guideline, or definition. Standards help to increase the reliability and the effectiveness of the goods and services we use.

Use of standards

Standards are used to objectively measure an organization’s performance. When the organization performs to the minimum level of desired standards, it will be awarded a license that allows it to deliver the services. As performance improves to the maximum level of standard as objectively measured, it will be Certified or Accredited for meeting the highest expected standards.


Standards describe explicitly who should be doing what, in which way, at which level of the health system at what time and the expected output.


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