Email this article 
Hide
Show all
Original Research
Progressing beyond SLMTA: Are internal audits and corrective action the key drivers of quality improvement?
Submitted: 11 August 2014 | Published: 03 November 2014
About the author(s)
Robert N. Maina, Kenya Accreditation Service (KENAS), KenyaDoris M. Mengo, Kenya Accreditation Service (KENAS), Kenya
Abdikher D. Mohamud, Kenya Accreditation Service (KENAS), Kenya
Susan M. Ochieng, Kenya Accreditation Service (KENAS), Kenya
Sammy K. Milgo, Kenya Accreditation Service (KENSAS), Kenya
Connie J. Sexton, United States Centers for Disease Control and Prevention, Atlanta, United States
Sikhulile Moyo, Botswana-Harvard AIDS Institute Partnership, Princes Marina Hospital, Botswana
Elizabeth T. Luman, United States Centers for Disease Control and Prevention, Atlanta, United States
Abstract
Background: Kenya has implemented the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme to facilitate quality improvement in medical laboratories and to support national accreditation goals. Continuous quality improvement after SLMTA completion is needed to ensure sustainability and continue progress toward accreditation.
Methods: Audits were conducted by qualified, independent auditors to assess the performance of five enrolled laboratories using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist. End-of-programme (exit) and one year post-programme (surveillance) audits were compared for overall score, star level (from zero to five, based on scores) and scores for each of the 12 Quality System Essential (QSE) areas that make up the SLIPTA checklist.
Results: All laboratories improved from exit to surveillance audit (median improvement 38 percentage points, range 5–45 percentage points). Two laboratories improved from zero to one star, two improved from zero to three stars and one laboratory improved from three to four stars. The lowest median QSE scores at exit were: internal audit; corrective action; and occurrence management and process improvement (< 20%). Each of the 12 QSEs improved substantially at surveillance audit, with the greatest improvement in client management and customer service, internal audit and information management (≥ 50 percentage points). The two laboratories with the greatest overall improvement focused heavily on the internal audit and corrective action QSEs.
Conclusion: Whilst all laboratories improved from exit to surveillance audit, those that focused on the internal audit and corrective action QSEs improved substantially more than those that did not; internal audits and corrective actions may have acted as catalysts, leading to improvements in other QSEs. Systematic identification of core areas and best practices to address them is a critical step toward strengthening public medical laboratories.
Keywords
Metrics
Total abstract views: 11475Total article views: 14223
Crossref Citations
1. A comprehensive review of the SLMTA literature part 2: Measuring success
Elizabeth T. Luman, Katy Yao, John N. Nkengasong
African Journal of Laboratory Medicine vol: 3 issue: 2 year: 2014
doi: 10.4102/ajlm.v3i2.276
2. Improving quality in national reference laboratories: The role of SLMTA and mentorship
Rosemary A. Audu, Catherine C. Onubogu, Nkiru N. Nwokoye, Eke Ofuche, Shirematee Baboolal, Odafen Oke, Elizabeth T. Luman, Emmanuel O. Idigbe
African Journal of Laboratory Medicine vol: 3 issue: 2 year: 2014
doi: 10.4102/ajlm.v3i2.200
3. Implementing a quality management system using good clinical laboratory practice guidelines at KEMRI-CMR to support medical research
Horace Gumba, Joseph Waichungo, Brett Lowe, Alfred Mwanzu, Robert Musyimi, Johnstone Thitiri, Caroline Tigoi, Martin Kamui, James A. Berkley, Ronald Ngetich, Susan Kavai, Samuel Kariuki
Wellcome Open Research vol: 3 first page: 137 year: 2019
doi: 10.12688/wellcomeopenres.14860.2
4. A comprehensive review of the SLMTA literature part 1: Content analysis and future priorities
Elizabeth T. Luman, Katy Yao, John N. Nkengasong
African Journal of Laboratory Medicine vol: 3 issue: 2 year: 2014
doi: 10.4102/ajlm.v3i2.265
5. Implementing a quality management system using good clinical laboratory practice guidelines at KEMRI-CMR to support medical research
Horace Gumba, Joseph Waichungo, Brett Lowe, Alfred Mwanzu, Robert Musyimi, Johnstone Thitiri, Caroline Tigoi, Martin Kamui, James A. Berkley, Ronald Ngetich, Susan Kavai, Samuel Kariuki
Wellcome Open Research vol: 3 first page: 137 year: 2018
doi: 10.12688/wellcomeopenres.14860.1
6. Review of the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) version 2:2015
Tjeerd A.M. Datema, Linda Oskam, Jacqueline E.W. Broerse, Paul R. Klatser
African Journal of Laboratory Medicine vol: 9 issue: 1 year: 2020
doi: 10.4102/ajlm.v9i1.1068
7. Internal auditing of hands-on teaching events improves learning among students in the clinical phase of the university level medical school
Ville Bister, Ilkka Helenius, Mikko Heinänen
Cogent Education vol: 13 issue: 1 year: 2026
doi: 10.1080/2331186X.2026.2654980
8. Multi-site comparison of factors influencing progress of African insecticide testing facilities towards an international Quality Management System certification
Sara Begg, Alex Wright, Graham Small, Matt Kirby, Sarah Moore, Ben Koudou, William Kisinza, Diabate Abdoulaye, Jason Moore, Robert Malima, Patrick Kija, Frank Mosha, Constant Edi, Imelda Bates, Ramzi Mansour
PLOS ONE vol: 16 issue: 11 first page: e0259849 year: 2021
doi: 10.1371/journal.pone.0259849
9. Critical success factors for Vietnamese laboratories striving to implement quality management systems
Cathy Robinson, James Johnson, Katy Yao, Hien Bui
African Journal of Laboratory Medicine vol: 9 issue: 1 year: 2020
doi: 10.4102/ajlm.v9i1.937
10. Enhancing accreditation outcomes for medical laboratories on the Strengthening Laboratory Management Toward Accreditation programme in Kenya via a rapid results initiative
Ernest P. Makokha, Raphael O. Ondondo, Daniel K. Kimani, Thomas Gachuki, Frank Basiye, Mercy Njeru, Muthoni Junghae, Marie Downer, Mamo Umuro, Margaret Mburu, Jane Mwangi
African Journal of Laboratory Medicine vol: 11 issue: 1 year: 2022
doi: 10.4102/ajlm.v11i1.1614
11. Implementation of a customised antimicrobial resistance laboratory scorecard in Cameroon, Ethiopia and Kenya
André Trollip, Renuka Gadde, Tjeerd Datema, Kamau Gatwechi, Linda Oskam, Zachary Katz, Andrew Whitelaw, Peter Kinyanjui, Patrick Njukeng, Dawit A. Wendifraw, Ibrahimm Mugerwa, Grace Najjuka, Nicholas Dayie, Japheth A. Opintan, Heidi Albert
African Journal of Laboratory Medicine vol: 11 issue: 1 year: 2022
doi: 10.4102/ajlm.v11i1.1476