Assessing the outcome of Strengthening Laboratory Management Towards Accreditation (SLMTA) on laboratory quality management system in city government of Addis Ababa, Ethiopia.

Abay Sisay,Adino Desale,Eyob Abera,Abrham Tesfaye,Tedla Mindaye

doi:10.11604/pamj.2015.20.314.5375

Abstract

IntroductionStrengthening Laboratory Management Toward Accreditation (SLMTA) is a competency-based management training programme designed to bring about immediate and measurable laboratory improvement. The aim of this study is to assess the outcome of SLMTA on laboratory quality management system in Addis Ababa, Ethiopia.MethodsThe study used an Institutional based cross sectional study design that employed a secondary and primary data collection approach on the participated institution of medical laboratory in SLMTA. The study was conducted in Addis Ababa city government and the data was collected from February ‘April 2014 and data was entered in to EPI-data version 3.1 and was analyzed by SPSS version 20.ResultsThe assessment finding indicate that there was a significant improvement in average scores (141.4; range of 65-196, 95%CI =86.275-115.5, p = 0.000) at final with 3 laboratories become 3 star, 6 laboratories were at 2 star, 11 were 1 star. Laboratory facilities respondents which thought getting adequate and timely manner mentorship were found 2.5 times more likely to get good success in the final score(AOR= 2.501, 95% CI= 1.109-4.602) than which did not get it.ConclusionAt the end of SLMTA implementation,3 laboratories score 3 star, 6 laboratories were at 2 star, 11 were at 1 star. The most important contributing factor for not scoring star in the final outcome of SLMTA were not conducting their customer satisfaction survey, poor staff motivation, and lack of regular equipment service maintenance. Mentorship, onsite and offsite coaching and training activities had shown a great improvement on laboratory quality management system in most laboratories.

Highlights

Strengthening Laboratory Management Toward Accreditation (SLMTA) is a competency-based management training programme designed to bring about immediate and measurable laboratory improvement
SLMTA were implemented on thirty one health facility laboratories (6 Hospital and 25 health centers), among them 29 facility laboratories were eligible for this study by using exclusion /inclusion criteria,4 hospital laboratory and 25 district health center laboratory which are found under city government of Addis Ababa and have been providing the clinical laboratory service for the People of the city and surrounding areas were assessed their status of the Quality System Essential before and after implementation of SLMTA at each Laboratory Facility by WHO-AFRO SLIPTA checklist
29 health institution laboratory were participated which full fill the inclusion criteria, among them 20 were health center and 4 were hospitals .Record review was done on the baseline and final assessment of SLMTA and the reviewed data indicate that the base line score of these 29 laboratory facilities ranges from 23 (9.2%) to 85 (34%) and indicate that all 29 laboratory facilities were in zero star level

Summary

Introduction

Strengthening Laboratory Management Toward Accreditation (SLMTA) is a competency-based management training programme designed to bring about immediate and measurable laboratory improvement. In USA study indicates that 6% to 12% of laboratory errors guide the patients at risk of inappropriate care and potentially of adverse events, and from 26% to 30% of errors have a negative impact on other aspects of patient care [5] By recognizing this gaps of the current state of laboratories and the requirements of ISO 15189 particular requirements for quality and competence, Ethiopia has implemented the WHO-AFRO Stepwise Laboratory Quality Improvement Process, SLMTA in 2009 in order to help laboratories with stepwise recognition of evolving fulfillment of the ISO 15189 standard instead a grading system of pass-fail [6]. After the launching of WHO-AFRO Stepwise Laboratory Accreditation Process in Ethiopia 2009, from the laboratories selected for accreditation program Addis Ababa Health research and Laboratory were the only lab score four star based on WHO AFRO assessment checklist (November 2011) up from a baseline of 0-star [7]. There is a gap in knowledge and availability of data, an urgent need to strengthen data and to make accessible evidence based information to the professional and the community on the outcome and factor affecting SLMTA and giving useful baseline information to policy and decision makers, program managers for all efforts that will be made to improve laboratory quality in future were the corner stone of this study

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