​The Best of the Recent Past: ​

Interview Recorded by Dr Shayan Anwar 

Interviewee: Associate Prof Shaista Afzal Radiology - MC​​

Q.1. Please briefly share your initial phase of journey i.e., from medical graduate to consultant. ​

Prof Shaista Afzal​​: I graduated from Dow Medical College, after which I completed my internship at Civil Hospital. I had never thought of becoming a radiologist. As time passed, I found radiology to be an emerging field and partook in it as a challenge. I began my residency in Radiology at Civil Hospital and after graduation, I started working at Liaqat National Hospital. Very soon I got the opportunity to work at AKU where I joined as an instructor. 

Q.2. Considering your entire time as a women imaging radiologist at your organization, can you recall a time (any AHAA moment) when you felt most alive or most excited about your involvement in the organization? 

Prof Shaista Afzal​​: A distinct time is when our department set up the section of Women Imaging. Aside from that, when we get the opportunity to apply the best possible practices in the field and are able to train and guide others both at AKU and other institutions in the country, I feel elated that we are able to make such a positive contribution. 

Q.3. Let’s consider for a moment the things you value deeply. Specifically, the things you value about yourself and the nature of your work, what is the single most important thing your work has contributed to your life?  

Prof Shaista Afzal​​:​ Work has added meaningfully to my life. Some of the useful qualities that I have learned through work are collegiality, discipline and perseverance.  

Q.4. As a senior women imaging radiologist of the country, please share your experience of development of women imaging practices in Pakistan and its future in next 10 years. 

Prof Shaista Afzal​​:​ There were and are many hurdles particularly related to the provision of equipment, training of faculty and staff and awareness in our population. Women commonly do not come for their breast screening. When they do the tumors have grown significantly. We have to increase awareness among women about their well-being through all channels such as media and health authorities. In the years to come, I do see some improvements but only after we get support from both the public and private sectors.  

Q.5. Any advice for Junior Radiologist? 

Prof Shaista Afzal​​:​ Over time radiology has been referred to as clinical imaging. Hence it is important to have all the information about your patient before you read any scan or perform any intervention. A holistic picture of the patient is vital for correct interpretation and better patient outcomes. I would also encourage junior radiologists to actively master the usage of technology and artificial intelligence as opposed to being hesitant in using them.  

Interview Recorded by Ms. Iffat Arman 

Interviewee: Mr. Abdul Mateen, Quality Control Coordinator, Chemical Pathology ​

​​​Accreditation of clinical laboratories according to an internationally accepted framework leads to improvement in quality practices of a laboratory, generation of accurate test results, reduction in errors and overall improved efficiency. Accreditations by College of American Pathologists (CAP) is a very rigorous practice. The CAP has more than 3500 standards that should be met. The Aga Khan Clinical Laborato​​ry was accredited by CAP in 2017 and since then have been reaccredited thrice.  

The main stakeholders and the persons doing all the work to achieve this daunting task are the faculty and staff of the clinical laboratory. However, the role each section of our clinical laboratory plays in clinical care are too many as well as very diverse, so we req​uested them to focus on two major areas only. We interviewed the Quality control coordinators of the sections to understand challenges faced by each section in achieving accreditation and how it has impacted their practices. 

Q.1. What were the challenges you faced while preparing your section for the CAP accreditation and how did you resolve these cha​llenges?  

Talking ​​about the challenges being faced some of them were tricky, firstly 2022 was the year for document revision and with a test menu of around 250 tests it was a huge task to achieve. Reviewing every single SOP, equipment work instruction, sectional policy, QM plan, sectional patient procedures and numerous other documents complaining CAP standards and in accordance with new hospital based templates. Challenging was the fact that these would go directly for document control to be reviewed by inspector and responsibility would be cater by sectional QC coordinator as directed by Director laboratory CAP.  

Q.2. How has CAP accreditation improved your clinical laboratory practices, quality assurance and patient safety in your sections? 

Quality control and error detection practices, document control, practices and procedures of lab improved, operations became lean and accurate, results reporting improved, staff efficiency increased, staff continued educational programs were developed, competency assessment of staff initiated. Compliance with the CAP standards lead to overall improvement of the test result quality and hence patient safety, raising the standards of care. Nevertheless, it was a team effort who spend hours and hours of working to achieve reaccreditation status unaccompanied by deficiencies. ​​


Interviewee: Ms. Ayman Jalali, Quality Control Coordinator, Blood Bank 

Q.1. What were the challenges you faced while preparing your section for the CAP accreditation and how did you resolve these challenges?  ​

Preparation for  CAP accreditation is always challenging. Some of the major issues which we faced are: 

Training and awareness of staff in the mid of pandemic: Due to Covid, it was very hard for us to conduct training and awareness sessions as we had to follow the strict Covid guidelines. Online sessions were arranged so that maximum number of participants can be trained at a ti​me.  

Revision of SOPs according to changes in checklist and its implementation: As revision in some of the standards demanded changes in current SOPs, so modifying the work flow and training the staff according to it was quite challenging. We conducted some pilot projects to see which solution suits us as we had to manage all these changes in current number of staff and limited space. Although it was very tough, but with team work and support of our respectable section heads and physicians, we made it possible. 

​Q.2. How has CAP accreditation improved your clinical laboratory practices, quality assurance and patient safety. ​

It has helped us in many ways. In blood bank, the introduction of Bedside ABO has helped in preventing wrong transfusions. Also, the introduction of Antibody screening before red cell transfusion has also contributed towards patient safety as it ensures safe transfusion. Quality standards of CAP which include continuous monitoring of QC and use of only CE/FDA approved reagents and instruments have let us improve our overall laboratory practices and quality assurance.​


Interviewee: Ms. Fauzia Naureen, Quality Control Coordinator, Haematology 

Q.1.   What were the challenges you faced while preparing your section for the CAP accreditation and how did you resolve these challenges? ​

The biggest challenge was announcement of dates just few days before the actual inspection. However, we were able to easily overcome this concern as CAP standards are now part of our daily work and extra preparations in this regard were not required. Our trust in each other as a team further boosted our confidence. Review of revised SOPs and Policies had to be done in very short time frame but our cooperation amongst us helped us achieve this task on time as well. 

Q.2. How has CAP accreditation improved your clinical laboratory practices, quality assurance and patient safety in your sections? ​​

CAP accreditation has brought remarkable improvement in our section. Our knowledge of quality assurance and staff practices regarding maintaining quality assurance have improved significantly. They now better understand the significance of fulfilling all desired QC steps. Implementation of advanced QC tools such as delta check, moving averages, validation of tests before implementation and participation in proficiency testing surveys on unknown samples are few examples that has contributed to culture of ensuring patient safety.


Interviewee: Ms. Samina Ghani, Quality Control Coordinator, Molecular Pathology 

Q.1. What were the challenges you faced while preparing your section for the CAP accreditation and how did you resolve these challenges?​

Molecular pathology is one of the most diverse section of clinical laboratory and its continuing evolving with new and recent technologies in research and diagnosis. This time Covid 19 is a great challenge for our laboratory and initially its very tough to maintain high volumes of covid 19 in limited resources with CAP parameters. But later on with support and encouragement of our management we introduced High Throughput automated testing and by the continuous struggle and hard work of our team we achieve the goal.  

Q.2. How has CAP accreditation improved your clinical laboratory practices, quality assurance and patient safety in your sections? 

CAP standards are very effective for highly complex molecular testing along with Quality assurance. It has great impact on validation of new tests. It improves testing efficiency, customer service and reduce rates of laborator​​y errors. CAP accreditation also improve our patient care by aiding the timeliness and accuracy of medical decision. our section also Participation in Proficiency testing(PT) which is a key component of accreditation, leads to more accurate test results. ​

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Interviewee: Ms. Najma Shaheen, Quality Control Coordinator, Microbiology  ​

Q.1. What were the challenges you faced while preparing your section for the CAP accreditation and how did you resolve these challenges? 

This CAP audit was delayed due to pandemic and conducted after 4 years gap. The challenges were related to the scarcity of human workforce not only to continue with the normal operations of the laboratory and simultaneously working on CAP related issue.  Hospital policy to minimize the exposure we had conducted online training and teaching    sessions which was a difficult task 

Q.2. How has CAP accreditation improved your clinical laboratory practices, quality assurance and patient safety in your sections?

  1. ​​​CAP accreditation help​​ us to manage rapidly evolving changes in laboratory 
  2. ​It help us to meet the standards from CLIA, CLSI  ,FDA.​​
  3. ​We have initiated quality projects. to improve quality process. ​


Interviewee: Ms. Somiayya Sohail, Quality Control Coordinator, Histopathology

​Q.1. What were the challenges you faced while preparing your section for the CAP accreditation and how did you resolve these challenges? ​

Preparing for the CAP inspection was a laborious task, but at the same time offered great learning experience. We had to cover almost 300 standards mentioned in the checklist, that has been provided by the College of American pathologists. These standards are pertinent to the areas of Anatomic pathology, Cytology, flowcytometry and semen analysis. Since there is heavy service load in our lab, accomplishment of this task has been challenging. A few exceptionally demanding tasks encountered during preparation included daily updating of equipment binders. Since service took most of our time during the morning hours, this part was done during the night duty hours. Another tedious task was to formulate a policy for the new standard that had been recently introduced by CAP. This was related to the fixation time of tissue. Since it was a new edition, we had to ensure that this policy was followed by consultants across the board. 

Q.2. How has CAP accreditation improved your clinical laboratory practices, quality assurance and patient safety in your sections? 

Implementing the CAP standards strictly reduces the chances of errors and improves accuracy of tests. This is related to the stringent quality assurance measures as laid down by CAP. 

In short, accreditation establishes safe practices that are necessary for accurate, reliable, and timely reporting of specimens. These measures are not only beneficial from the patient perspective, but also provide a safe working environment for the laboratory personnel.