A comprehensive review of the SLMTA literature part 2: Measuring success

Luman, Elizabeth T.; Yao, Katy; Nkengasong, John N.

doi:10.4102/ajlm.v3i2.276

Cited by 17 publications

(17 citation statements)

References 33 publications

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“…These QSEs are common low-scoring areas, as reported in Lesotho 16 and other countries. 18 In Ghana, these deficiencies were largely a result of a lack of internal audit skills, inadequate staffing, limited experience of mentors, inefficient communication channels and institutional bottlenecks, such as administrative and procurement 7 processes. As a result of these findings, training on internal audit has been conducted for all laboratory and quality managers, in collaboration with GSA.…”

Section: Discussionmentioning

confidence: 99%

Building local human resources to implement SLMTA with limited donor funding: The Ghana experience

et al. 2014

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Background In 2009, Ghana adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme in order to improve laboratory quality. The programme was implemented successfully with limited donor funding and local human resources. Objectives To demonstrate how Ghana, which received very limited PEPFAR funding, was able to achieve marked quality improvement using local human resources. Method Local partners led the SLMTA implementation and local mentors were embedded in each laboratory. An in-country training-of-trainers workshop was conducted in order to increase the pool of local SLMTA implementers. Three laboratory cohorts were enrolled in SLMTA in 2011, 2012 and 2013. Participants from each cohort attended in a series of three workshops interspersed with improvement projects and mentorship. Supplemental training on internal audit was provided. Baseline, exit and follow-up audits were conducted using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist. In November 2013, four laboratories underwent official SLIPTA audits by the African Society for Laboratory Medicine (ASLM). Results The local SLMTA team successfully implemented three cohorts of SLMTA in 15 laboratories. Seven out of the nine laboratories that underwent follow-up audits have reached at least one star. Three out of the four laboratories that underwent official ASLM audits were awarded four stars. Patient satisfaction increased from 25% to 70% and sample rejection rates decreased from 32% to 10%. On average, $40 000 was spent per laboratory to cover mentors' salaries, SLMTA training and improvement project support. Conclusion Building in-country capacity through local partners is a sustainable model for improving service quality in resource-constrained countries such as Ghana. Such models promote country ownership, capacity building and the use of local human resources for the expansion of SLMTA.

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Section: Discussionmentioning

confidence: 99%

Building local human resources to implement SLMTA with limited donor funding: The Ghana experience

et al. 2014

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“…Similar rapid and tangible improvements resulting from SLMTA training have been reported by other countries. 15 , 16 …”

Section: Discussionmentioning

confidence: 99%

Laboratory system strengthening and quality improvement in Ethiopia

et al. 2014

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Background In 2010, a National Laboratory Strategic Plan was set forth in Ethiopia to strengthen laboratory quality systems and set the stage for laboratory accreditation. As a result, the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme was initiated in 45 Ethiopian laboratories. Objectives This article discusses the implementation of the programme, the findings from the evaluation process and key challenges. Methods The 45 laboratories were divided into two consecutive cohorts and staff from each laboratory participated in SLMTA training and improvement projects. The average amount of supportive supervision conducted in the laboratories was 68 hours for cohort I and two hours for cohort II. Baseline and exit audits were conducted in 44 of the laboratories and percent compliance was determined using a checklist with scores divided into zero- to five-star rating levels. Results Improvements, ranging from < 1 to 51 percentage points, were noted in 42 laboratories, whilst decreases were recorded in two. The average scores at the baseline and exit audits were 40% and 58% for cohort I (p < 0.01); and 42% and 53% for cohort II (p < 0.01), respectively. The p-value for difference between cohorts was 0.07. At the exit audit, 61% of the first and 48% of the second cohort laboratories achieved an increase in star rating. Poor awareness, lack of harmonisation with other facility activities and the absence of a quality manual were challenges identified. Conclusion Improvements resulting from SLMTA implementation are encouraging. Continuous advocacy at all levels of the health system is needed to ensure involvement of stakeholders and integration with other improvement initiatives and routine activities.

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“…Part 2, published separately, compiles the quantitative data reported in the publications, examines scores and indicators, and uses meta-analysis to augment the results. 6 …”

Section: Introductionmentioning

confidence: 99%

A comprehensive review of the SLMTA literature part 1: Content analysis and future priorities

2014

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BackgroundSince its introduction in 2009, the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme has been implemented widely throughout Africa, as well as in the Caribbean, Central and South America, and Southeast Asia.ObjectiveWe compiled results from local, national and global studies to provide a broad view of the programme and identify directions for the future. The review consists of two companion papers; this paper focuses on content analysis, examining various thematic components of the SLMTA programme and future priorities.MethodsA systematic literature search identified 28 published articles about implementing the SLMTA programme. Results for various components of the SLMTA programme were reviewed and summarised.ResultsLocal and national studies provide substantial information on previous experiences with quality management systems; variations on SLMTA implementation; building human resource capacity for trainers, mentors and auditors; the benefits and effectiveness of various types of mentorship; the importance of management buy-in to ensure country ownership; the need to instill a culture of quality in the laboratory; success factors and challenges; and future directions for the programme.ConclusionsLocal, national and global results suggest that the SLMTA programme has been overwhelmingly successful in transforming laboratory quality management. There is an urgent need to move forward in four strategic directions: progression (continued improvement in SLMTA laboratories), saturation (additional laboratories within countries that have implemented SLMTA), expansion (implementation in additional countries), and extension (adapting SLMTA for implementation beyond the laboratory), to lead to transformation of overall health systems and patient care.

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A comprehensive review of the SLMTA literature part 2: Measuring success

Cited by 17 publications

References 33 publications

Building local human resources to implement SLMTA with limited donor funding: The Ghana experience

Building local human resources to implement SLMTA with limited donor funding: The Ghana experience

Laboratory system strengthening and quality improvement in Ethiopia

A comprehensive review of the SLMTA literature part 1: Content analysis and future priorities

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