Original Research

Creating a sustainable culture of quality through the SLMTA programme in a district hospital laboratory in Kenya

Phidelis M. Maruti, Ekesa A. Mulianga, Lorna N. Wambani, Melda N. Wafula, Fidelis A. Mambo, Shadrack M. Mutisya, Eric N. Wakaria, Erick M. Mbati, Angela A. Amayo, Jonathan M. Majani, Bryan Nyary, Kilian A. Songwe
African Journal of Laboratory Medicine | Vol 3, No 2 | a201 | DOI: https://doi.org/10.4102/ajlm.v3i2.201 | © 2014 Phidelis M. Maruti, Ekesa A. Mulianga, Lorna N. Wambani, Melda N. Wafula, Fidelis A. Mambo, Shadrack M. Mutisya, Eric N. Wakaria, Erick M. Mbati, Angela A. Amayo, Jonathan M. Majani, Bryan Nyary, Kilian A. Songwe | This work is licensed under CC Attribution 4.0
Submitted: 22 May 2014 | Published: 16 September 2014

About the author(s)

Phidelis M. Maruti, Ministry of Health-Kenya, Kenya
Ekesa A. Mulianga, Ministry of Health-Kenya, Kenya
Lorna N. Wambani, Ministry of Health-Kenya, Kenya
Melda N. Wafula, Ministry of Health-Kenya, Kenya
Fidelis A. Mambo, Department of Health Sciences, Masinde Muliro University, Kenya
Shadrack M. Mutisya, A Global Healthcare Public Foundation, Kenya
Eric N. Wakaria, Management Sciences for Health-Kenya, Kenya
Erick M. Mbati, AIDS, Population and Health Integrated Assistance Plus (APHIA PLUS) Western, Kenya
Angela A. Amayo, Management Sciences for Health-Kenya, Kenya
Jonathan M. Majani, Ministry of Health-Kenya, Kenya
Bryan Nyary, International Healthcare and Development, Kenya
Kilian A. Songwe, A Global Healthcare Public Foundation, Kenya


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Abstract

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.


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Crossref Citations

1. Progressing beyond SLMTA: Are internal audits and corrective action the key drivers of quality improvement?
Robert N. Maina, Doris M. Mengo, Abdikher D. Mohamud, Susan M. Ochieng, Sammy K. Milgo, Connie J. Sexton, Sikhulile Moyo, Elizabeth T. Luman
African Journal of Laboratory Medicine  vol: 3  issue: 2  year: 2014  
doi: 10.4102/ajlm.v3i2.222