Original Research
Creating a sustainable culture of quality through the SLMTA programme in a district hospital laboratory in Kenya
Submitted: 22 May 2014 | Published: 16 September 2014
About the author(s)
Phidelis M. Maruti, Ministry of Health-Kenya, KenyaEkesa 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
Abstract
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
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