Open AccessCreating a sustainable culture of quality through the SLMTA programme in a district hospital laboratory in Kenya
Author(s) -
Phidelis M Maruti,
Ekesa A Mulianga,
Lor Wambani,
Melda N Wafula,
Fidelis Mambo,
Shadrack M Mutisya,
Eric N. Wakaria,
Erick M Mbati,
Angela Amayo,
Jonathan M Majani,
Bryan Nyary,
Kilian A Songwe
Publication year - 2014
Publication title -
african journal of laboratory medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 11
eISSN - 2225-2010
pISSN - 2225-2002
DOI - 10.4102/ajlm.v3i2.201
Subject(s) - accreditation , quality management , audit , medicine , punctuality , quality audit , psychological intervention , mentorship , organizational culture , quality management system , pdca , hospital accreditation , nursing , operations management , medical education , business , engineering , management system , public relations , political science , accounting , transport engineering
Background Bungoma District Hospital Laboratory (BDHL), which supports a 200-bed referral facility, began its Strengthening Laboratory Management Toward Accreditation (SLMTA) journey in 2011 together with eight other laboratories in the second round of SLMTA rollout in Kenya. Objectives To describe how the SLMTA programme and enhanced quality interventions changed the culture and management style at BDHL and instilled a quality system designed to sustain progress for years to come. Methods SLMTA implementation followed the standard three-workshop series, mentorship site visits and audits. In order to build sustainability of progress, BDHL integrated quality improvement processes into its daily operations. The lab undertook a process of changing its internal culture to align all hospital stakeholders – including upper management, clinicians, laboratory staff and maintenance staff – to the mission of sustainable quality practices at BDHL. Results After 16 months in the SLMTA programme, BDHL improved from zero stars (38%) to four stars (89%). Over a period of two to three years, external quality assessment results improved from 47% to 87%; staff punctuality increased from 49% to 82%; clinician complaints decreased from 83% to 16; rejection rates decreased from 12% to 3%; and annual equipment repairs decreased from 40 to 15. Twelve months later the laboratory scored three stars (81%) in an external surveillance audit conducted by Kenya Accreditation Service (KENAS). Conclusion Management buy-in, staff participation, use of progress-monitoring tools and feedback systems, as well as incorporation of improvement processes into routine daily activities, were vital in developing and sustaining a culture of quality improvement.