Abstract
BackgroundThe Ministry of Health (MOH) of Botswana adopted Strengthening Laboratory Management Toward Accreditation (SLMTA), a structured quality improvement programme, as a key tool for the implementation of quality management systems in its public health laboratories. Coupled with focused mentorship, this programme aimed to help MOH achieve the goals of the National Laboratory Strategic Plan to provide quality and timely clinical diagnoses.ObjectivesThis article describes the impact of implementing SLMTA in Sekgoma Memorial Hospital Laboratory (SMHL) in Serowe, Botswana.MethodsSLMTA implementation in SMHL included trainings, improvement projects, site visits and focused mentorship. To measure progress, audits using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist were conducted at baseline and exit of the programme, with scores corresponding to a zero- to five-star scale. Turnaround times, customer satisfaction, and several other health service indicators were tracked.ResultsThe laboratory scored 53% (zero stars) at the baseline audit and 80% (three stars) at exit. Nearly three years later, the laboratory scored 85% (four stars) in an official audit conducted by the African Society for Laboratory Medicine. Turnaround times became shorter after SLMTA implementation, with reductions ranging 19% to 52%; overall patient satisfaction increased from 56% to 73%; and clinician satisfaction increased from 41% to 72%. Improvements in inventory management led to decreases in discarded reagents, reducing losses from US $18 000 in 2011 to $40 in 2013.ConclusionThe SLMTA programme contributed to enhanced performance of the laboratory, which in turn yielded potential positive impacts for patient care at the hospital.
Highlights
Laboratory medicine plays a critical role in healthcare and public health,[1,2,3] and expanding laboratory capacity has been a focus of funding partners such as the US President’s Emergency Plan for AIDS Relief (PEPFAR).[4]
Considerable resources have been invested in recent years for the improvement of laboratory systems in resource-limited settings, lack of access to reliable laboratory testing still remains a barrier to effective healthcare and treatment for diseases, including tuberculosis, HIV and malaria.[5,6,7]
Turnaround times decreased for all tests monitored: 19% reduction for haematology tests, 44% for chemistry tests, 30% for cerebrospinal fluid (CSF) analyses and 52% for pregnancy tests (Figure 1)
Summary
Laboratory medicine plays a critical role in healthcare and public health,[1,2,3] and expanding laboratory capacity has been a focus of funding partners such as the US President’s Emergency Plan for AIDS Relief (PEPFAR).[4]. Previous training of healthcare workers has focused on general management topics rather than identifying tangible tasks to bring about change, making the training difficult to apply in the laboratory.[10] In 2009, the MOH developed a Health Sector Laboratory Strategic Plan for 2009–2014, in which laboratory accreditation was a stated goal: to have four district-level laboratories accredited by 2013 and two national-level laboratories accredited by 2014. To spearhead the MOH’s National Laboratory Strategic Plan, Strengthening Laboratory Management Toward Accreditation (SLMTA), a structured quality improvement programme, was selected to assist in the development of QMS http://www.ajlmonline.org doi:10.4102/ajlm.v3i2.209. The Ministry of Health (MOH) of Botswana adopted Strengthening Laboratory Management Toward Accreditation (SLMTA), a structured quality improvement programme, as a key tool for the implementation of quality management systems in its public health laboratories. This programme aimed to help MOH achieve the goals of the National Laboratory Strategic Plan to provide quality and timely clinical diagnoses
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