Look out For

THE REPUBLIC OF UGANDA MINISTRY OF HEALTH Partnering for Development EDITION 5 ISSUE 1 Above:Environmental safeguards contractor inspecting the site for the MDR TB ward in Moroto LOOK OUT FOR: Mentorship model for medical Senior World Bank Director laboratories in East Africa Scores for WHO-AFRO visits SRL in Uganda SLIPTA audit April 2018 Points 250 200 150 100 50 0 Mulago National Ref Moroto RRH St. Mary's Lacor Mbarara RRH Mbale RRH Fort Portal RRH UCI Makerere University lab Laboratory Laboratory Laboratory Laboratory Laboratory Hitopathology Also: Operational Research done by EAPHLN EAST AFRICA PUBLIC HEALTH LABORATORY NETWORKING PROJECT THE REPUBLIC OF UGANDA MINISTRY OF HEALTH Implementing Laboratory Quality Management systems in Uganda By Patricia Akello-Anok performing in its mission to improve the health of “There is a misconception that the QMS the citizens. The experience of QMS implementation implementation is an and lessons learnt are shared herein. expensive activity which The EAPHLNP has been supporting six increases workload and laboratories for the past eight years and an adds extra layers of bureaucracy. However, if additional two laboratories for the past to years. well planned, appropriately These laboratories have undergone progressive resourced, and efficiently transformation since they adopted and integrated implemented, QMS provides quality management in their system. Among other a cost-effective management achievements, the project has improved testing system.” capacity by provision of state of the art critical Before the Maputo Declaration on Strengthening of equipment necessary for efficient laboratory service Laboratory Systems in 2008 and the 2012 African delivery. Technical assistance to facility personnel Society for Laboratory Medicine Ministerial Call for has been provided by mentors who have built Action, the concept of quality management systems capacity through on-site and off-site trainings. in laboratories was uncommon in Africa. Fortunately, in the last few years, Health ministries and health Mentors also identify training needs and other implementing partners have given considerable associated gaps, and make recommendations to the attention to support laboratories effectively manage project for support. and deliver quality services. The adoption of the quality management approach to deliver quality services has been driven by a number of imperatives such as the aspiration to satisfy the increasing demands by laboratory users. Health laboratories have now embarked on establishing quality management systems in order to improve the quality of service they offer. A quality management system (QMS) is a coordinated aggregate of interrelated and interactive activities that determine quality policy and objectives and provides health care organisations with guidance and rules in their However, despite concerted efforts by different goal attainment. The implementation of quality players to strengthen QMS in the recent past, management systems enables health care medical laboratories in Uganda have not received organisations to define and manage processes that full implementation although the current ISO ensure delivery of services that meet customer 15189 standard requires that every laboratory needs and expectations. It also instils trust in both should have a documented quality system to the organization and clients in respect to service manage all its technical and management quality and conformity to standards. processes. Laboratories in the public sector continue to face challenges in implementing and Quality improvement unites the health workforce by maintaining documented quality systems. These enhancing individual performance, job satisfaction challenges include inadequate knowledge and and retention. Quality in health care is the guiding resources required to implement principle in assessing how well the health system is a QMS and achieve accreditation. The success 2 EAST AFRICA PUBLIC HEALTH LABORATORY NETWORKING PROJECT THE REPUBLIC OF UGANDA MINISTRY OF HEALTH of a QMS is dependent on resources devoted to managerial staff otherwise changes will be resisted meet specified requirements. Also key is active or reluctantly adopted. Key personnel guide and participation of individuals and teams whose quicken change processes, however, the rate at attitude play a pivotal role for better execution. which personnel incorporate changes in their Quality experts urge that top management operations varies and this impacts on success of the commitment to quality is crucial for provision of QMS implementation. adequate resources and motivation of employees. In some laboratories mentors employed an The need to increase support to strengthen and incremental approach where a QMS was developed improve the quality of medical laboratory services in small areas to raise confidence and staff buy-in, in the country is paramount. leading to the implementation of QMS in other Implementation Strategies broader areas. Mentors helped the sites to develop quality teams which are a key factor in the success Mixed method strategies have been used to offer of a QMS. technical assistance to personnel, most notable being the mentorship strategy. Mentorship models used vary from the one to one approach and the one to many approach, trained personnel then cascaded acquired knowledge to their colleagues through different fora like continuous medical education sessions. Trainings were offered either onsite or off site depending on the scope. Opportunities to visit already accredited laboratories helped staff appreciate and have a clearer picture of the Mentorship in Eritrea desired QMS. Progress of QMS implementation Accreditation ebers eetin was measured using the World Health Organization A full-time quality manager (QM) at a senior level Regional Office for Africa Stepwise Laboratory is strongly recommended. It is important that (Quality) Improvement Process Towards this individual is committed to service during the Accreditation (WHO/AFRO– SLIPTA). development, implementation and subsequent phases of the QMS. Laboratories that changed At the onset, laboratorians received QMS quality managers during QMS development have implementation with mixed feelings: many grappled with implementation. The QM is the thought it was a fad that would come to pass; driving force behind the QMS and its associated others tagged QMS to individuals; and there was pertaining issues. A QM with a specific set of skills, resistance in some instances as implementers knowledge, and character traits earns the trust thought it was tedious, expensive and time of top management and directly accesses it. The consuming. Other laboratories, however, quickly appointed individual should have a strong desire embraced and integrated QMS in their systems. and interest in undertaking challenges associated These “early-adopter” laboratories soon stood out with developing and implementing a QMS. Forced as seen in their SLIPTA performance although or political appointments usually undermine the their oscillating star performance clearly reflect QMS and result in its failure. inconsistent implementation. First-hand experience also suggests that factors Documenting QMS implementation is a process such as the size of the organisation, maturity of that requires changes in all laboratory processes. the organisation’s processes and documentation, It is therefore helpful that mentors study and availability of resources, and facility top understand laboratory operations before suggesting management and staff commitment directly affect changes. It is important that change processes the rate and duration of QMS implementation. are calculative, consultative and agreeable to 3 EAST AFRICA PUBLIC HEALTH LABORATORY NETWORKING PROJECT THE REPUBLIC OF UGANDA MINISTRY OF HEALTH misunderstood documenting non-conformities Lessons learnt as a means of reporting an individual for punitive Although there has been overall improvement in purposes. It therefore should be clear that such the pre analytic, analytic and post analytical documentation are only intended for tracking phases as seen by improvement in the SLIPTA system improvement, scores, the country needs to invest more and tackle The QMS foundation should be built on its issues hindering laboratories from attaining Principles Customer ocus Leadership international accreditation. nolement of people rocess Approach System There is a misconception that the QMS Approach to management Continuous implementation is an expensive activity improement actual Approach to Decision maing which increases workload and adds extra and Mutual beneficial supplier relationships woven into the processes, outcomes and overall culture of layers of bureaucracy. However, if well the organisation. planned, appropriately resourced, and efficiently implemented, QMS provides a cost-effective management system. A key to a successful QMS is the availability of data to provide objective information as a The adoption of a QMS should be a strategic measure of conformity to policies, objectives, management decision with specific needs, objectives and activities to influence the goals and key performance indicators such as development and implementation of the QMS. customer satisfaction measures It is important to identify and train appropriate Several factors have contributed to the sluggish staff with the right qualities and attitude to implementation of QMS in public health undertake specific roles such as internal auditors. laboratories: issues such

Load more