Physicians’ satisfaction with clinical referral laboratories in Rwanda

Figures & data

Table 1. Socio-demographic characteristics of participants

Demographic characteristics (n = 462)	Frequencies	Percentage
Institutions
Hospital-1	92	19.9
Hospital-2	238	51.5
Hospital-3	67	14.5
Hospital-4	65	14.1
Gender:
Male	355	76.8
Female	107	23.2
Age:
25–35	272	58.9
36–45	143	31.0
46–55	35	7.6
56–65	12	2.6
Physician categories
Specialists(consultants)	166	35.9
Residents	275	59.5
General practitioners	21	4.6
Years of experience
<5	150	32.5
5–15	275	59.5
16–25	24	5.2
26–35	13	2.8

Table 2. Aggregate of physicians’satisfaction and mean scores in laboratory services

	Satisfied^f	Neutral	Dissatisfied^g	Mean of Likert score
Laboratory service categories (n = 462)	No. (%)	No. (%)	No. (%)	(SD)
Overall satisfaction	167(36.2)	208(45.0)	87(18.8)	3.2(0.8)
Availability of laboratory tests	151(32.7)	198(42.9)	113(24.5)	3.1(0.8)
Availability of infections tests	157(34.0)	179(38.7)	126 (27.3)	3.1(0.9)
Lab mgt ability to find solutions^a	173(37.5)	190(41.1)	99(21.4)	3.2(0.9)
Courtesy of laboratory staff	217(47.0)	182(39.4)	63(13.6)	3.4(0.9)
Availability of laboratory staff	270(58.4)	145(31.4)	47(10.2)	3.6(0.9)
Laboratory leadership responsiveness	237(51.3)	160(34.6)	65(14.1)	3.3(0.9)
Collaboration of laboratory staff	191(41.3)	164(35.5)	107(23.2)	3.2(1.0)
Critical values notification	177(38.3)	122(26.4)	163(35.3)	3.1(1.2)
Communication of changes^b	134(29.0)	156(33.8)	172(37.2)	2.9(1.1)
Routine tests TAT^c	89(19.3)	197(42.7)	175 (38.0)	2.7(0.9)
Inpatient stat test TAT^d	125(27.1)	191(41.3)	146(31.6)	2.9(0.9)
Sensitivity for emergency tests^e	149(32.3)	165(35.7)	148(32.0)	3.0(1.0)
Reliability of laboratory tests	323(69.9)	121(26.2)	18(3.9)	3.8(0.8)
Adequacy of laboratory tests reports	286(61.9)	135(29.2)	41(8.9)	3.7(0.8)
Missing laboratory results in outpatient	143(31.0)	228(49.4)	91(19.7)	3.1(0.9)
Missing laboratory results in inpatient	177(38.3)	191(41.3)	9(20.4)	3.2(0.9)

^aLaboratory management ability to find solutions.

^bChanges in laboratory that may guide clinicians to adapt their laboratory request.such as reagent stock out, new tests, equipment broken, etc

^cTAT is Turnaround time.

^dStat test is a test that needs an urgent result for decision on management of patient(s).

^eLaboratory service and staff sensitivity for emergency tests requests.

^fSatisfied is the combination of satisfied and strongly satisfied from the Likert five-point scale.

^gDissatisfied is the combination of dissatisfied and strongly dissatisfied from the Likert five-point scale.

Table 3. Bivariate and multivariate analysis to assess predicator variables for physicians’ overall satisfaction

General satisfaction				Ordered logistic regression
Demographic variables	Satisfied^a No. (%)	Neutral No. (%)	Dissatisfied^b No. (%)	Crude OR(CI)*	Adjusted OR(CI)
Institutions
Hospital-1	31(33.7)	43(46.7)	18(19.6)	1	1
Hospital-2	109(45.8)	89(37.4)	40(16.8)	1.53(0.97–2.42)	1.84(1.11–3.05)
Hospital-3	16(23.9)	40(59.7)	11(16.4)	0.82(0.46–1.41)	0.89(0.46–1.71)
Hospital-4	11(16.9)	36(55.4)	18(27.7)	0.52(0.29–0.95)	0.71(0.38–1.34)
Gender
Male	137(38.6)	155(43.7)	63(17.8)	1	1
Female	30(28.0)	53(49.5)	24(22.4)	0.66(0.44–1)	0.91(0.59–1.42)
Age
25–35	101(37.1)	120(44,1)	51(18.8)	1
36–45	49(34.3)	64(44.8)	30(21.0)	0.87(0.58–1.28)
46–55	14(40.0)	16(45.7)	5(14.3)	1.19(0.61–2.30)
56–65	3(25.0)	8(66.7)	1(8.3)	0.90(0.32–2.49)
Physician categories
Specialists (Consultants)	49(29.5)	89(53.6)	28(16.9)	1	1
Residents	104(37.8)	114(41.5)	57(20.7)	1.15(0.80–1.65)	0.84(0.50–1.42)
General practitioners	14(66.6)	5(23.8)	2(9.5)	3.88(1.50–10)	2.73(0.88–8.46)
Years of experience
<1	44(37.6)	52(44.4)	21(18.0)	1	1
1–5	90(34.0)	126(47.6)	49(18.5)	0.89(0.59–1.33)	0.74(0.47–1.17)
6–10	27(56.3)	12(25.0)	9(18.8)	1.80(0.92–3.5)	1.23(0.55–2.73)
>10	6(18.8)	18(56.3)	8(25.0)	0.51(0.25–1.05)	0.32(0.11–0.90)
Nationality
Rwandan	147(34.4)	196(45.9)	84(19.7)	1	1
Non-Rwandan	20(60.6)	10(30.3)	3(9.1)	2.86(1.40–5.9)	1.47(0.65–3.33)
Departments
Anesthesiology	37(44.6)	35(42.2)	11(13.3)	1	1
Pediatrics	19(22.9)	39(47.0)	25(30.1)	0.35(0.20–0.64)	0.44(0.24–0.82)
Obstetrics & Gynecology	25(39.1)	25(39.1)	14(21.9)	0.69(0.37–1.30)	0.77(0.39–1.51)
Internal medicine	33(29.0)	55(48.3)	26(22.8)	0.50(0.3–0.87)	0.64(0.36–1.14)
Surgery	50(43.9)	53(46.5)	11(9.7)	1.04(0.61–1.79)	1.23(0.69–2.19)

*OR: Odds Ratio.

CI: Confidence Interval.

^aSatisfied is the combination of satisfied and strongly satisfied from the Likert five-point scale.

^bDissatisfied is the combination of dissatisfied and strongly dissatisfied from the Likert five-point scale.

Table

Test NAME	Description	TAT in Hours
A/G Ratio	Albumin/Globulin ratio	2
AFB CULTURE (BK/BAAR)	Liquide culture for TB	1008
AFB Staining (BK/BAAR)	Auramine/ziel	12
AFP	Alfa-Feto-Protein	2
ALAT/SGPT A	Alanine Amino Transferase ARCHITEC	2
ALAT/SGPT C	Alanine Amino Transferase Cobas c311	2
Albumin A	ARCHITECT	2
Albumin Body fluid	Albumin in (CSF, Ascitis, pleural, pericardial, synovial)	2
Albumin c	Cobas c311	2
Alkaline phosphatase A	ARCHITECH	2
Alkaline phosphatase C	Cobas c311	2
Alpha-fetoprotein(AFP)	RACHITECT	2
Amylase A	ARCHITECT	2
Amylase C	Cobas c 311	2
AMYLASURIE	AMYLASE IN URINE	2
APTT	Activated Partial Prothromboplastin Time	2
ASAT/SGOT A	Aspartate Amino Transferase ARCHITECT	2
ASAT/SGOT C	Aspartate Amino Transferase on c311	2
GGT A	Gamma GlytamylTransferase ARCHITEC	2
GGT C	Gamma GlytamylTransferase Cobas c311	2
Ascitis bacteriology	Cyto-Bacteriological Exam of ascitis	72
Ascitis chemistry		2
ASLO	Anti Strepto Lysine O	2
BAL bacteriology	Cyto-Bacteriological exam of bronchoalveolar lavage	72
Base excess		2
Bile salts		2
Bilirubinuria		1
FERRITIN	FERRITIN	2
HCO3-	Bicabonate	2
Calcium A	ARCHITEC	2
Calcium C	COBAS C311	2
Caliciuria	Calcium in urine	2
Caryotype	Karyotype	720
Cervical swab bacteriology	Cyto-Bacteriological exam of cervical swab	72
Chloride A	ARCHITEC	2
Chloride Body fluid	Chloride in (CSF, Ascitis, pleural, pericardial, synovial)	2
Chloride C	Cobas c311	2
Cholesterol Esters		2
CK-MB A	Creatinine Kinase Muscle Brain ARCHITEC	2
CK-MB C	Creatinine Kinase Muscle Brain Cobas c311	2
CK-MM	Creatinine Kinase Muscle Muscle	2
CO2 Tot	Carbon monoxyde total	2
Coproculture		72
CPK	CreatininPhospho kinase	2
Creatinine A	Creatinine ARCHITEC	2
Creatinine C	Creatinin Cobas c311	2
Creatininuria	Creatinine in urine	2
CRP abort	C Reactive Protein	2
CRP humatex	C-reactive protein	2
Cryptococcal Ag	Cryptococcal Antigen	2
CSF bacteriology	Cyto-Bacteriological Exam of CSF	72
CSF chemistry	Glucose, protein, LDH, Pandy	2
HDL Cholesterol A	HDL Cholesterol ARCHITEC	2
HDL Cholesterol C	HDL Cholesterol Cobas c311	2
Direct bilirubin C	Direct bilirubin Cobas c 311	2
Direct bilirubin C	Direct bilirubin ARCHITEC	2
Direct Coombs		2
DSE/EDS	Direct Stool Examination wet preparation	2
DSE/EDS Concentration	Direct Stool Examination with concetration	2
DSE/EDS Staining	Direct Stool Examination with special staining	2
EBV Ab ELISA	Antibody Anti Epstein-Barr Virus ELISA	2
EBV Ab Rapid	Antibody Anti Epstein-Barr Virus Rapid test	2
EID (DBS)	Qualitative Test	336
FBC/NFS		2
ESR/VS	Erythrocyte Sedimentation Rate	2
Blood group/Groupe sanguin		2
BT/TS	Bleeding Time	2
CT/TC	Clotting Time	2
Ascitic cytology	Cytology of ascitic fluid	2
INR	International Normalized Ratio	2
CSF Cytology	Cytology of Cerebro Spinal Fluid	2
Hemostasis		2
FIB	Fibrinogen	2
Reticulocytes		2
Sickle Cell Test		2
Sickle cell test/Test d`Emmel		7
PT/TP	Prothrombine Time	2
F PSA	Prostatic Specific Antigen	2
Estradiol	Oestradiol hormone	2
FNA	Cytopathology	2
Free βHCG	Beta Human Chorionic Gonadothropine	2
FSH	Follicular Stimulating Hormon	2
FT3	Tri-Iodo-Thyronine hormone	2
FT4	Tetra-Iodo-Thyronine	2
Gene Xpert		4
Globulins		2
Glucose Body fluid	Glucose in (CSF, Ascitis, pleural, pericardial, synovial)	2
GLUCOSURIA C	Glucose in urine Cobas c311	1
Glycemia A	ARCHITEC	2
Glycemia C	Blood glucose Cobas c311	2
Glycosylated Hb A1C/HbGlyquee A	Glycosylated Hb A1C/HbGlyquee ARCHITEC	2
Glycosylated Hb A1C/HbGlyquee C	Glycosylated Hb A1C/HbGlyquee Cobas c311	2
H-Pylori Ab ELISA	Antibody anti H-Pylori ELISA	2
H-Pylori Ab Rapid	Antibody anti H-Pylori Rapid test	2
HB Viral load	Quantitative test	720
HBcAb ELISA	Antibody anti Hepatitis B core antigen ELISA	2
HBcAb Rapid	Antibody anti Hepatitis B core antigen Rapid test	2
HBeAb ELISA	Antibody anti Hepatitis B e-antigen ELISA	2
HBeAb Rapid	Antibody anti Hepatitis B e-antigen Rapid test	2
HBeAg ELISA	ELISA test for Hepatitis B e antigen	2
HBs Ab ELISA	Antibody anti Hepatitis B surface antigen ELISA	2
HBs Ab Rapid	Antibody anti Hepatitis B surface antigen Rapid test	2
HBsAg ELISA	ELISA test for Hepatitisa B surface antigen	2
HBsAg rapid	Hepatitis B surface antigen	2
HC Viral Load	Quantitative test	720
HCV Ab ELISA	Antibody anti Hepatitis C virus ELISA	2
HCV Ab Rapid	Antibody anti Hepatitis C virus	2
Hemoculture	Blood culture	168
Histopathology/Examend’une piece operatoire		168
HIV ELISA	HIV	168
HIV Rapid	HIV	1
HIV Viral Load	quantitative Test	168
Indirect bilirubin		2
Indirect Coombs		2
IRON A	SERUM IRON ARCHITEC	2
IRON C	Serum iron Cobas c311	2
Kaliuria	Potassium in urine	2
Keton bodies	Test is performed in urine	1
LDH A	Lactate Deshydrogenase ARCHITEC	2
LDH Body fluid	LDH in (CSF, Ascitis, pleural, pericardial, synovial)	2
LDH C	Lactate Deshydrogenase Cobas c311	2
LDL Cholesterol A	LDL Cholesterol ARCHITEC	2
LDL Cholesterol C	LDL Cholesterol Cobas c311	2
LH	Luteinizing Hormon	2
Line probe Assay (Hain test)		48
Lipase A	Lipase ARCHITEC	2
Lipase C	Lipase Cobas c311	2
Lithium		2
Magnesium A	Magnesium ARCHITEC	2
Magnesium C	Magnesium Cobas c311	2
Myelogram	Bone marrow cell count	4
Nasal swab bacteriology	Cyto-Bacteriological exam of nasal swab	72
Natriuria	Sodium in urine	2
One micturation quantitative proteinuria		2
Ordinary culture		72
PBF	Peripheral blood film	2
pCO2	Partial pressure of Carbon dioxyde	2
Pericardial bacteriology	Cyto-Bacteriological Exam of pericardial fluid	72
Pericardial chemistry		2
Pericardial cytology	Cytology of pericardial fluid	2
pH Blood		0.33
pH Urine		1
Phospholipid		2
Phosphoriuria	Phosphorous in urine	2
Phosphorous A	Phosphorous ARCHITECT	2
Pleural bacteriology	Cyto-Bacteriological Exam of pleural fluid	72
Pleural chemistry		2
Pleural cytology	Cytology of pleural fluid	2
pO2	Partial pressure of Oxygen	2
Potassium A	Potassium ARCHITEC	2
Potassium C	Potassium Cobas c311	2
Pregnancy test		2
Progesterone	Progesterone hormone	2
Prolactin	Prolactin hormone	2
Prostatic acid phosphatase		2
Protein Body fluid	Protein in (CSF, Ascitis, pleural, pericardial, synovial)	2
PROTEIN IN CSF		1
Prothrombine Rate	Prothrombine Rate	2
Pus swab bacteriology	Cyto-Bacteriological exam of pus wab	72
Qualitative Glucosuria		1
Qualitative Proteinuria A	ARCHITEC	1
Qualitative Proteinuria C	Qualitative Protein in urine Cobas c311	1
Quantitative proteinuria 24 h A	ARCHITEC	2
Quantitative proteinuria 24 h C	Cobas c311	2
QulitativeGlucosuria A	Glucosuria ARCHITEC	1
Rectal swab bacteriology	Cyto-Bacteriological exam of rectal swab	72
Rhumatoid factor		2
RPR	Rapid Plasma Reagin	2
Rubella Ab ELISA	Antibody anti Rubela ELISA	2
Rubella Ab Rapid	Antibody anti Rubella rapid test	2
Semen bacteriology/Spermoculture	Cyto-Bacteriological Exam of semen	72
Skin swab bacteriology	Cyto-Bacteriological exam of skin swab	72
Sodium A	Sodium ARCHITEC	2
Sodium C	Sodium Cobas c311	2
SODIUM IN URINE	SODIUM IN URINE	2
Spermogram		48
Sputum bacteriology	Cyto-Bacteriological exam of sputum	72
St HCO3-	Saturated bicarbonate	2
Synovial bacteriology	Cyto-Bacteriological Exam of Synovial Fluid	72
Synovial chemistry		2
Synovial cytology	Cytology of synovial fluid	2
T PSA	Prostatic Specific Antigen	2
T T3	Tri-iodo-thyronine hormone	2
Testosterone	Testosterone hormone	2
Thick smear+Parasitemia	GE + parasitemia	1
Throat Swab bacteriology	Cyto-Bacteriological exam of throat Swab	72
TIBC A	Total Ion Capacity Binding ARCHITEC	2
TIBC C	Total Ion Capacity Binding Cobas c311	2
Total acid phosphatase		2
Total bilirubin A	Total bilirubin ARCHITEC	2
Total bilirubin C	Total bilirubin Cobas c311	2
Total cholesterol A	Total cholesterol ARCHITEC	2
Total cholesterol C	Total cholesterol Cobas c311	2
Total glycosylated Hb/HbGlyquee		2
Total lipid		2
Total protein A	Total protein ARCHITEC	2
Total protein C	Total protein Cobas c311	2
TOTAL βHCG	Beta Human Chorionic Gonadothropine	2
Toxoplasma Ab ELISA	Antibody anti Toxoplasma ELISA	2
Toxoplasma Ab Rapid	Antibody anti Toxoplasma Rapid test	2
TPHA	TreponemaPallidumHemaglutination Essay	2
Transferrin		2
Triglycerides A	Triglycerides ARCHITEC	2
Triglycerides C	Triglycerides Cobas c311	2
Troponin I		2
TSH	Thyroid Stimulating Hormone	2
TT	Thrombine Time	2
TT4	Total Tetra-iodo-Thyronine	2
Urates blood		2
Urates urine		2
UREA A	UREA ARCHITEC	2
UREA C	UREA Cobas c311	2
Ureauria	Urea in urine	2
Urethral swab bacteriology	Cyto-Bacteriological exam of urethral swab	72
URIC ACID A	URIC ACID ARCHITEC	2
URIC ACID C	URIC ACID Cobas c311	2
Urinalysis/ECBU	Cyto-Bacteriological Exam of urine	72
Urine amylase		2
Urine density		1
Urobilinogenuria		1
Urobilinuria		2
Vaginal swab bacteriology	Cyto-Bacteriological exam of sputum vaginal swab	72
VDRL/RPR	Manual	2
Vitamin A	Automated	2
Vitamin B12	Automated	2
Wet preparation		1