Overview of the Implementation of Quality Management System in Nigerian Medical Laboratories

Abstract

Background: Quality Management System (QMS) is implemented in laboratory medicine to ensure that accurate, precise and timely results are achieved with the overall goal being to accomplish patients’ satisfaction. Through QMS, laboratories achieve competence in technical ability and ensure that active quality management of professional services and those of personnel are maintained with or without the ultimate aim of obtaining accreditation. Objective: To provide information on status, in-country structures, challenges and prospect of quality management system, and its implementation in Nigerian Medical Laboratories. Materials and Methods: Published literature, online reports and websites related to the implementation of laboratory QMS, accreditation and WHO/AFRO Strengthening Laboratory Management towards Accreditation and Stepwise Laboratory Quality Improvement Process towards Accreditation SLMTA/SLIPTA programme. Results: Quality Management System is relatively new in Nigerian medical laboratories as only a few are accredited. Majority of the facilities implementing QMS are those involved in diagnosis, management and surveillance of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) and tuberculosis. QMS is mostly implemented in Nigeria through WHO AFRO SLMTA/SLIPTA programme. This has brought about improved and sustained quality management. Factors such as poor infrastructure, climate extremes, financial constraints, gaps in capacity building, lack of equipment and consumables, and dedicated and motivated personnel have been challenges. Major strength is in implementing the twelve quality essential elements and International Organization of Standardization (ISO) 15189 clauses are facility and safety, while documents and record, internal audits, as well as occurrence management is quite challenging. Aspiring laboratories need to start gradually and strongly advocating for management support, connect to national regulations and also participate in External Quality Assurance (EQA) programmes. Others are to observe and understand the local scene, find support and allies, keep documents and communication simple and straightforward and learn from previous mistakes. Laboratory personnel should imbibe positive behavioural change to promote quality in practice, be creative, with the ability to identify and adapt to local solutions, stimulate ownership and create a positive climate. Conclusion: Awareness has been created but more needs to be done for laboratory personnel to understand the processes involved, as well as ways to handle challenges and implement Quality Management System. Intensified efforts are needed to enrol private and public facilities involved in hospital based patient care.