Lessons from the Field

From benchmarking to best practices: Lessons from the laboratory quality improvement programme at the military teaching hospital in Cotonou, Benin

Alban Zohoun, Tatiana B. Agbodandé, Angélique Kpadé, Raliatou O. Goga, René Gainsi, Paul Balè, Bibata M. Sambo, Remi Charlebois, Rachel Crane, Michele Merkel, Ludovic Anani, Ekaterina Milgotina
African Journal of Laboratory Medicine | Vol 10, No 1 | a1057 | DOI: https://doi.org/10.4102/ajlm.v10i1.1057 | © 2021 Alban Zohoun | This work is licensed under CC Attribution 4.0
Submitted: 06 June 2019 | Published: 11 February 2021

About the author(s)

Alban Zohoun, Department of Hematology, Faculty of Health Sciences, National University Hospital Center - Hubert Koutoukou Maga, Cotonou, Benin; and, Army Teaching Hospital, University Hospital Center, Cotonou,, Benin
Tatiana B. Agbodandé, Department of Hematology, Faculty of Health Sciences, National University Hospital Center - Hubert Koutoukou Maga, Cotonou, Benin
Angélique Kpadé, Army Teaching Hospital, University Hospital Center, Cotonou, Benin
Raliatou O. Goga, Army Teaching Hospital, University Hospital Center, Cotonou, Benin
René Gainsi, Army Teaching Hospital, University Hospital Center, Cotonou, Benin
Paul Balè, Army Teaching Hospital, University Hospital Center, Cotonou, Benin
Bibata M. Sambo, Army Teaching Hospital, University Hospital Center, Cotonou, Benin
Remi Charlebois, Global Scientific Solutions for Health (GSSHealth), Baltimore, Maryland, United States
Rachel Crane, Global Scientific Solutions for Health (GSSHealth), Baltimore, Maryland, United States
Michele Merkel, Global Scientific Solutions for Health (GSSHealth), Baltimore, Maryland, United States
Ludovic Anani, Department of Hematology, Faculty of Health Sciences, National University Hospital Center - Hubert Koutoukou Maga, Cotonou, Benin
Ekaterina Milgotina, Global Scientific Solutions for Health (GSSHealth), Baltimore, Maryland, United States


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Abstract

Background: In 2015, the Army Teaching Hospital–University Teaching Hospital (HIA-CHU [Hôpital D’instruction des Armées de Cotonou Centre Hospitalier et Universitaire]) laboratory in Benin launched a quality improvement programme in alignment with the World Health Organization Regional Office for Africa’s Stepwise Laboratory Improvement Process Towards Accreditation (SLIPTA). Among the sub-Saharan African laboratories that have used SLIPTA, few have been francophone countries, and fewer have belonged to a military health system. The purpose of this article was to outline the strategy, implementation, outcomes and military-specific challenges of the HIA-CHU laboratory quality improvement programme from 2015 to 2018.

Intervention: The strategy for the quality improvement programme included: external baseline SLIPTA evaluation, creation of work plan based on SLIPTA results, execution of improvement projects guided by work plan, assurance of accountability via regular meetings, training of personnel to improve personnel competencies, development of external stakeholder relationships for sustainability and external follow-up post-SLIPTA evaluation.

Lessons learnt: Over a period of 3 years, the HIA-CHU laboratory improved its SLIPTA score by 29% through a quality improvement process guided by work plan implementation, quality management system documentation, introduction of new proficiency testing and internal quality control programmes, and enhancement of personnel competencies in technical and quality management through training.

Recommendations: The programme has yielded achievements, but consistent improvement efforts are necessary to address programme challenges and ensure continual increases in SLIPTA scores. Despite successes, military-specific challenges such as the high mobility of personnel have hindered programme progress. The authors recommend that further implementation research data be shared from programmes using SLIPTA in under-represented settings such as military health systems.


Keywords

laboratory medicine; Stepwise Laboratory Improvement Process Towards Accreditation; SLIPTA; quality improvement; laboratory quality improvement; military laboratory; quality assurance; SLMTA; Strengthening Laboratory Management Toward Accreditation

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