Improving quality in national reference laboratories: The role of SLMTA and mentorship

Audu, Rosemary; Onubogu, Catherine; Nwokoye, Nkiru N.; Ofuche, Eke; Baboolal, Shirematee; Oke, Odafen; Luman, Elizabeth T.; Idigbe, Emmanuel O.

doi:10.4102/ajlm.v3i2.200

Cited by 13 publications

(35 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other studies have also noted that supplementing SLMTA with additional training and mentoring may be beneficial. 9,10,11 Our findings, when joined with these others, suggest that combining SLMTA with other strategies in a QMS programme may lead to synergistic improvement.…”

Section: Discussionsupporting

confidence: 60%

See 1 more Smart Citation

Accelerating the spread of laboratory quality improvement efforts in Botswana

Mokobela¹,

Moatshe²,

Modukanele

2014

Afr J Lab Med

View full text Add to dashboard Cite

BackgroundIn 2002, the Ministry of Health (MoH) of Botswana began its journey toward laboratory accreditation in an effort to enhance the quality of laboratory services. After a difficult start, the MoH recognised the need for a more practical and sustainable method for change that could be implemented nationally; they therefore adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme.ObjectiveThis study describes the process and lessons learned in implementing SLMTA and the role of supplemental training and mentoring so as to achieve Botswana’s national laboratory quality improvement goal.MethodsEight laboratories were enrolled into the SLMTA programme in 2010, which included a series of workshops and improvement projects conducted over nine months. Four of these laboratories received supplementary training and focused mentorship from the Botswana Bureau of Standards (BOBS). Laboratory performance was measured at baseline and exit using the World Health Organization Regional Office for Africa’s Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist. One laboratory did not receive an exit audit and was thus excluded from the analysis.ResultsAn 18 percentage-point improvement was observed when comparing the median baseline score (53%) to the median exit score (71%) for the seven laboratories. Laboratories that received additional training and mentorship from BOBS improved 21 percentage points, whilst non-BOBS-mentored laboratories improved eight percentage points. Hospital management buy-in and strong laboratory staff camaraderie were found to be essential for the positive changes observed.ConclusionSLMTA facilitated improvements in laboratory quality management systems, yielding immediate and measurable results. This study suggests that pairing the SLMTA programme with additional training and mentorship activities may lead to further increases in laboratory performance; and that SLMTA is a practical approach to extending quality improvement to MOH laboratories.

show abstract

Section: Discussionsupporting

confidence: 60%

“…9 This checklist yields qualitative results rather than a numerical score and highlights areas of focus for accreditation preparation.…”

Section: Research Methods and Designmentioning

confidence: 99%

Accelerating the spread of laboratory quality improvement efforts in Botswana

Mokobela¹,

Moatshe²,

Modukanele

2014

Afr J Lab Med

View full text Add to dashboard Cite

show abstract

“…9 SLMTA mentorship approaches have ranged from standard short-term visits 10,11 to newer models of peer or embedded mentoring. 11,12 In the standard short-term model, a mentor visits the mentee laboratory and stays in the laboratory for a short stint, often a week or less. During this period, the laboratory quality officer works under the guidance of the mentor to address laboratory quality gaps identified during prior assessment.…”

Section: Introductionmentioning

confidence: 99%

Using standard and institutional mentorship models to implement SLMTA in Kenya

et al. 2014

Self Cite

View full text Add to dashboard Cite

BackgroundKenya is home to several high-performing internationally-accredited research laboratories, whilst most public sector laboratories have historically lacked functioning quality management systems. In 2010, Kenya enrolled an initial eight regional and four national laboratories into the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme. To address the challenge of a lack of mentors for the regional laboratories, three were paired, or ‘twinned’, with nearby accredited research laboratories to provide institutional mentorship, whilst the other five received standard mentorship.ObjectivesThis study examines results from the eight regional laboratories in the initial SLMTA group, with a focus on mentorship models.MethodsThree SLMTA workshops were interspersed with three-month periods of improvement project implementation and mentorship. Progress was evaluated at baseline, mid-term, and exit using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) audit checklist and scores were converted into a zero- to five-star scale.ResultsAt baseline, the mean score for the eight laboratories was 32%; all laboratories were below the one-star level. At mid-term, all laboratories had measured improvements. However, the three twinned laboratories had increased an average of 32 percentage points and reached one to three stars; whilst the five non-twinned laboratories increased an average of 10 percentage points and remained at zero stars. At exit, twinned laboratories had increased an average 12 additional percentage points (44 total), reaching two to four stars; non-twinned laboratories increased an average of 28 additional percentage points (38 total), reaching one to three stars.ConclusionThe partnership used by the twinning model holds promise for future collaborations between ministries of health and state-of-the-art research laboratories in their regions for laboratory quality improvement. Where they exist, such laboratories may be valuable resources to be used judiciously so as to accelerate sustainable quality improvement initiated through SLMTA.

show abstract

“…Our LQSI approach using a full-time staff of embedded quality improvement mentors has proven highly effective in implementing a quality management system in a large number of hospital laboratories in a relatively short period. Others have demonstrated that mentorship assists laboratories to implement quality improvement activities 23 , 24 , 31 . However, we have shown how the regular presence of fully dedicated mentors and a detailed quality management system action plan in the local language improves the rate of quality management system implementation.…”

Section: Discussionmentioning

confidence: 62%

Implementation research: a mentoring programme to improve laboratory quality in Cambodia

Perrone

Voeurng

Sek

et al. 2016

Bull. World Health Organ.

View full text Add to dashboard Cite

ObjectiveTo implement a mentored laboratory quality stepwise implementation (LQSI) programme to strengthen the quality and capacity of Cambodian hospital laboratories.MethodsWe recruited four laboratory technicians to be mentors and trained them in mentoring skills, laboratory quality management practices and international standard organization (ISO) 15189 requirements for medical laboratories. Separately, we trained staff from 12 referral hospital laboratories in laboratory quality management systems followed by tri-weekly in-person mentoring on quality management systems implementation using the LQSI tool, which is aligned with the ISO 15189 standard. The tool was adapted from a web-based resource into a software-based spreadsheet checklist, which includes a detailed action plan and can be used to qualitatively monitor each laboratory’s progress. The tool – translated into Khmer – included a set of quality improvement activities grouped into four phases for implementation with increasing complexity. Project staff reviewed the laboratories’ progress and challenges in weekly conference calls and bi-monthly meetings with focal points of the health ministry, participating laboratories and local partners. We present the achievements in implementation from September 2014 to March 2016.FindingsAs of March 2016, the 12 laboratories have completed 74–90% of the 104 activities in phase 1, 53–78% of the 178 activities in phase 2, and 18–26% of the 129 activities in phase 3.ConclusionRegular on-site mentoring of laboratories using a detailed action plan in the local language allows staff to learn concepts of quality management system and learn on the job without disruption to laboratory service provision.

show abstract

Improving quality in national reference laboratories: The role of SLMTA and mentorship

Cited by 13 publications

References 11 publications

Accelerating the spread of laboratory quality improvement efforts in Botswana

Accelerating the spread of laboratory quality improvement efforts in Botswana

Using standard and institutional mentorship models to implement SLMTA in Kenya

Implementation research: a mentoring programme to improve laboratory quality in Cambodia

Contact Info

Product

Resources

About