Clinical Referral Laboratory Personnel’s Perception of Challenges and Strategies for Sustaining the Laboratory Quality Management System

Abstract

ObjectivesTo explore challenges explaining the decrease in quality performance and suggest strategies to improve and sustain laboratory quality services.MethodsTwenty key informants’ interviews from laboratory personnel were conducted in five laboratories. Four had previously shown a decrease in quality performance. Interviews were transcribed verbatim and analyzed using inductive thematic analysis.ResultsTwo themes emerged: (1) insufficient coordination and follow-up system towards accreditation, where lack of coordination, follow-up, and audits explained the decrease in performance; (2) inadequate resource optimization, where insufficient knowledge in Laboratory Quality Management System (LQMS), ownership by laboratory workforce, and insufficient stakeholders’ communication contributed to low-quality performance.ConclusionsThe coordination, follow-up, and assessments of LQMS, in conjunction with training of laboratory workforce, would establish an institutional culture of continuous quality improvement (CQI) towards accreditation and sustainment of quality health care. To achieve CQI culture, routine gap checking and planning for improvement using a system approach is required.

Physicians’ satisfaction with clinical referral laboratories in Rwanda

“…Reciprocal communication and a discussion platform for stakeholders could offer a better solution for service improvement. Studies recently conducted in these laboratories also found a communication gap between laboratories and clinicians and poor performance in conducting management reviews [ 9 , 11 , 22 ]. These reviews should discuss the underlined issues, strategies, and the role of each stakeholder in a laboratory improvement program.…”

“…They are equipped with modern laboratory equipment. Recent studies in these laboratories did not find that personnel and finance were a challenge for quality [ 11 , 15 ]. The four laboratories are technically supervised by the NRL.…”

“…In Rwanda, the quality of health care is at the heart of health sector and it is recurrent in its planning circle. The accreditation of health facilities has been ongoing for more than a decade [9][10][11][12][13][14]. Starting in 2010, clinical referral laboratories embarked on the accreditation process and have received different quality performance scores over the years [9][10][11].…”

Digital Management Systems in Academic Health Sciences Laboratories: A Scoping Review

“…However, as Timoteo et al [ 6 ] discussed, the complex nature of the provided services of multiuser, academic research facilities may impair the obtention of feedback through quantitative indicators. In this sense, the perception and attitudes of staff towards the management system may contribute to understanding its impact on the workflow and the search for quality at academic clinical research laboratories, as well as provide data for the development or improvement of actions and strategies toward quality and compliance [ 31 , 32 , 33 ]. In this sense, validated tools may provide a means to standardize the evaluation of laboratory management software, allowing comparisons on the effectiveness and adequacy of these systems in different applications.…”

The impact of online management systems: a qualitative assessment of staff perception at a clinical research laboratory

“…However, the lack of evidence in the scientific literature on how the use of informatics, through online management systems, may contribute to administration of communications, stock, and shared used of resources, limits the rational use of these tools in the search for quality and good practices at Nevertheless, other parameters may effectively contribute to understanding the influence of OMS on the search for quality at academic clinical research laboratories, such as the perception and attitudes of staff towards laboratory management and workflow. Indeed, several authors (Lulie et al, 2014;Presot et al, 2014;Rusanganwa et al, 2019) have shown that insights on the experience and perception of the laboratory staff and collaborators may provide data for the development or improvement of actions and strategies, as well as training the workforce in the dissemination of laboratory quality, and strengthening management toward accreditation.…”