scholarly journals Developing a customised approach for strengthening tuberculosis laboratory quality management systems toward accreditation

2017 ◽  
Vol 6 (2) ◽  
Author(s):  
Heidi Albert ◽  
Andre Trollip ◽  
Donatelle Erni ◽  
Kekeletso Kao
Keyword(s):  
Quality Improvement ◽  
Quality Management ◽  
Quality Management System ◽  
World Health Organisation ◽  
World Health ◽  
Laboratory Management ◽  
Regional Office ◽  
Quality Improvement Process ◽  
Early Implementation ◽  
Training Of Trainers

Background: Quality-assured tuberculosis laboratory services are critical to achieve global and national goals for tuberculosis prevention and care. Implementation of a quality management system (QMS) in laboratories leads to improved quality of diagnostic tests and better patient care. The Strengthening Laboratory Management Toward Accreditation (SLMTA) programme has led to measurable improvements in the QMS of clinical laboratories. However, progress in tuberculosis laboratories has been slower, which may be attributed to the need for a structured tuberculosis-specific approach to implementing QMS. We describe the development and early implementation of the Strengthening Tuberculosis Laboratory Management Toward Accreditation (TB SLMTA) programme.Development: The TB SLMTA curriculum was developed by customizing the SLMTA curriculum to include specific tools, job aids and supplementary materials specific to the tuberculosis laboratory. The TB SLMTA Harmonized Checklist was developed from the World Health Organisation Regional Office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation checklist, and incorporated tuberculosis-specific requirements from the Global Laboratory Initiative Stepwise Process Towards Tuberculosis Laboratory Accreditation online tool.Implementation: Four regional training-of-trainers workshops have been conducted since 2013. The TB SLMTA programme has been rolled out in 37 tuberculosis laboratories in 10 countries using the Workshop approach in 32 laboratories in five countries and the Facility based approach in five tuberculosis laboratories in five countries.Conclusion: Lessons learnt from early implementation of TB SLMTA suggest that a structured training and mentoring programme can build a foundation towards further quality improvement in tuberculosis laboratories. Structured mentoring, and institutionalisation of QMS into country programmes, is needed to support tuberculosis laboratories to achieve accreditation.

scholarly journals Implementation of the World Health Organization Regional Office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Jean-Bosco Ndihokubwayo ◽  
Talkmore Maruta ◽  
Nqobile Ndlovu ◽  
Sikhulile Moyo ◽  
Ali Ahmed Yahaya ◽  
...  
Keyword(s):  
Quality Improvement ◽  
World Health Organization ◽  
Continuous Quality Improvement ◽  
World Health ◽  
Regional Office ◽  
Quality Improvement Process ◽  
Continuous Quality ◽  
The World ◽  
Health Organization ◽  
World Health Organization Regional

Background: The increase in disease burden has continued to weigh upon health systems in Africa. The role of the laboratory has become increasingly critical in the improvement of health for diagnosis, management and treatment of diseases. In response, the World Health Organization Regional Office for Africa (WHO AFRO) and its partners created the WHO AFRO Stepwise Laboratory (Quality) Improvement Process Towards Accreditation (SLIPTA) program.SLIPTA implementation process: WHO AFRO defined a governance structure with roles and responsibilities for six main stakeholders. Laboratories were evaluated by auditors trained and certified by the African Society for Laboratory Medicine. Laboratory performance was measured using the WHO AFRO SLIPTA scoring checklist and recognition certificates rated with 1–5 stars were issued.Preliminary results: By March 2015, 27 of the 47 (57%) WHO AFRO member states had appointed a SLIPTA focal point and 14 Ministers of Health had endorsed SLIPTA as the desired programme for continuous quality improvement. Ninety-eight auditors from 17 African countries, competent in the Portuguese (3), French (12) and English (83) languages, were trained and certified. The mean score for the 159 laboratories audited between May 2013 and March 2015 was 69% (median 70%; SD 11.5; interquartile range 62–77). Of these audited laboratories, 70% achieved 55% compliance or higher (2 or more stars) and 1% scored at least 95% (5 stars). The lowest scoring sections of the WHO AFRO SLIPTA checklist were sections 6 (Internal Audit) and 10 (Corrective Action), which both had mean scores below 50%.Conclusion: The WHO AFRO SLIPTA is a process that countries with limited resources can adopt for effective implementation of quality management systems. Political commitment, ownership and investment in continuous quality improvement are integral components of the process.

scholarly journals Mozambique’s journey toward accreditation of the National Tuberculosis Reference Laboratory

2017 ◽  
Vol 6 (2) ◽  
Author(s):  
Sofia O. Viegas ◽  
Khalide Azam ◽  
Carla Madeira ◽  
Carmen Aguiar ◽  
Carolina Dolores ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Management ◽  
Quality Management System ◽  
Action Plan ◽  
Test Reliability ◽  
Reference Laboratory ◽  
Iso 15189 ◽  
Quality Improvement Process ◽  
Improvement Process ◽  
National Tuberculosis

Background: Internationally-accredited laboratories are recognised for their superior test reliability, operational performance, quality management and competence. In a bid to meet international quality standards, the Mozambique National Institute of Health enrolled the National Tuberculosis Reference Laboratory (NTRL) in a continuous quality improvement process towards ISO 15189 accreditation. Here, we describe the road map taken by the NTRL to achieve international accreditation.Methods: The NTRL adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme as a strategy to implement a quality management system. After SLMTA, the Mozambique National Institute of Health committed to accelerate the NTRL’s process toward accreditation. An action plan was designed to streamline the process. Quality indicators were defined to benchmark progress. Staff were trained to improve performance. Mentorship from an experienced assessor was provided. Fulfilment of accreditation standards was assessed by the Portuguese Accreditation Board.Results: Of the eight laboratories participating in SLMTA, the NTRL was the best-performing laboratory, achieving a 53.6% improvement over the SLMTA baseline conducted in February 2011 to the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) assessment in June 2013. During the accreditation assessment in September 2014, 25 minor nonconformities were identified and addressed. In March 2015, the NTRL received Portuguese Accreditation Board recognition of technical competency for fluorescence smear microscopy, and solid and liquid culture. The NTRL is the first laboratory in Mozambique toachieve ISO 15189 accreditation.Conclusions: From our experience, accreditation was made possible by institutional commitment, strong laboratory leadership, staff motivation, adequate infrastructure and a comprehensive action plan.

scholarly journals Accelerating the spread of laboratory quality improvement efforts in Botswana

2014 ◽  
Vol 3 (2) ◽  
Author(s):  
Kelebeletse O. Mokobela ◽  
Mpho T. Moatshe ◽  
Mosetsanagape Modukanele
Keyword(s):  
Quality Improvement ◽  
World Health ◽  
Regional Office ◽  
Laboratory Performance ◽  
Additional Training ◽  
Laboratory Staff ◽  
Quality Improvement Process ◽  
Percentage Points ◽  
Laboratory Services ◽  
Health Organization

Background: In 2002, the Ministry of Health (MoH) of Botswana began its journey toward laboratory accreditation in an effort to enhance the quality of laboratory services. Aftera difficult start, the MoH recognised the need for a more practical and sustainable method for change that could be implemented nationally; they therefore adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme.Objective: This study describes the spread of laboratory quality improvement efforts in Botswana.Methods: Eight laboratories were enrolled into the SLMTA programme in 2010, which included a series of workshops and improvement projects conducted over nine months. Four of these laboratories received supplementary training and focused mentorship from the Botswana Bureau of Standards (BOBS). Laboratory performance was measured at baseline and exit using the World Health Organization Regional Office for Africa’s StepwiseLaboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist. One laboratory did not receive an exit audit and was thus excluded from the analysis.Results: An 18 percentage-point improvement was observed when comparing the median baseline score (53%) to the median exit score (71%) for the seven laboratories. Laboratories that received additional training and mentorship from BOBS improved 21 percentage points, whilst non-BOBS-mentored laboratories improved eight percentage points. Hospital management buy-in and strong laboratory staff camaraderie were found to be essential forthe positive changes observed.Conclusion: SLMTA facilitated improvements in laboratory quality management systems,yielding immediate and measurable results. This study suggests that pairing the SLMTA programme with additional training and mentorship activities may lead to further increases in laboratory performance; and that SLMTA is a practical approach to extending quality improvement to MOH laboratories.

scholarly journals Innovative strategies for a successful SLMTA country programme: The Rwanda story

2014 ◽  
Vol 3 (2) ◽  
Author(s):  
Innocent Nzabahimana ◽  
Sabin Sebasirimu ◽  
John B. Gatabazi ◽  
Emmanuel Ruzindana ◽  
Claver Kayobotsi ◽  
...  
Keyword(s):  
Quality Improvement ◽  
World Health ◽  
Reference Laboratory ◽  
Regional Office ◽  
Innovative Strategies ◽  
Quality Improvement Process ◽  
Performance Based Financing ◽  
One Year ◽  
Health Organization

Background: In 2009, to improve the performance of laboratories and strengthen healthcare systems, the World Health Organization Regional Office for Africa (WHO AFRO) and partners launched two initiatives: a laboratory quality improvement programme called Strengthening Laboratory Management Toward Accreditation (SLMTA), and what is now called the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA).Objectives: This study describes the achievements of Rwandan laboratories four years after the introduction of SLMTA in the country, using the SLIPTA scoring system to measure laboratory progress.Methods: Three cohorts of five laboratories each were enrolled in the SLMTA programme in 2010, 2011 and 2013. The cohorts used SLMTA workshops, improvement projects, mentorship and quarterly performance-based financing incentives to accelerate laboratory quality improvement. Baseline, exit and follow-up audits were conducted over a two-year period from the time of enrolment. Audit scores were used to categorise laboratory quality on a scale of zero (< 55%) to five (95% – 100%) stars.Results: At baseline, 14 of the 15 laboratories received zero stars with the remaining laboratory receiving a two-star rating. At exit, five laboratories received one star, six received two stars and four received three stars. At the follow-up audit conducted in the first two cohorts approximately one year after exit, one laboratory scored two stars, five laboratories earned three stars and four laboratories, including the National Reference Laboratory, achieved four stars.Conclusion: Rwandan laboratories enrolled in SLMTA showed improvement in quality management systems. Sustaining the gains and further expansion of the SLMTA programme to meet country targets will require continued programme strengthening.

scholarly journals Quality management systems in Aboriginal Community Controlled Health Services: a review of the literature

2021 ◽  
Vol 10 (3) ◽  
pp. e001091
Author(s):  
Jenifer Olive Darr ◽  
Richard C Franklin ◽  
Kristin Emma McBain-Rigg ◽  
Sarah Larkins ◽  
Yvette Roe ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Management ◽  
Health Service ◽  
First Nations ◽  
Quality Management System ◽  
Grey Literature ◽  
Models Of Care ◽  
Clinical Governance ◽  
Aboriginal Community ◽  
Continuous Quality

BackgroundA national accreditation policy for the Australian primary healthcare (PHC) system was initiated in 2008. While certification standards are mandatory, little is known about their effects on the efficiency and sustainability of organisations, particularly in the Aboriginal Community Controlled Health Service (ACCHS) sector.AimThe literature review aims to answer the following: to what extent does the implementation of the International Organisation for Standardization 9001:2008 quality management system (QMS) facilitate efficiency and sustainability in the ACCHS sector?MethodsThematic analysis of peer-reviewed and grey literature was undertaken from Australia and New Zealand PHC sector with a focus on First Nations people. The databases searched included Medline, Scopus and three Informit sites (AHB-ATSIS, AEI-ATSIS and AGIS-ATSIS). The initial search strategy included quality improvement, continuous quality improvement, efficiency and sustainability.ResultsSixteen included studies were assessed for quality using the McMaster criteria. The studies were ranked against the criteria of credibility, transferability, dependability and confirmability. Three central themes emerged: accreditation (n=4), quality improvement (n=9) and systems strengthening (n=3). The accreditation theme included effects on health service expenditure and clinical outcomes, consistency and validity of accreditation standards and linkages to clinical governance frameworks. The quality improvement theme included audit effectiveness and value for specific population health. The theme of systems strengthening included prerequisite systems and embedded clinical governance measures for innovative models of care.ConclusionThe ACCHS sector warrants reliable evidence to understand the value of QMSs and enhancement tools, particularly given ACCHS (client-centric) services and their specialist status. Limited evidence exists for the value of standards on health system sustainability and efficiency in Australia. Despite a mandatory second certification standard, no studies reported on sustainability and efficiency of a QMS in PHC.

scholarly journals CURRENT ISSUES OF THE INTERRELATIONSHIP BETWEEN THE ENVIRONMENT AND HUMAN HEALTH IN EUROPEAN UNION COUNTRIES. LITERATURE REVIEW

2019 ◽  
Vol 98 (5) ◽  
pp. 473-477 ◽  
Author(s):  
Irina A. Pogonysheva ◽  
D. A. Pogonyshev
Keyword(s):  
Human Health ◽  
Environmental Control ◽  
World Health Organisation ◽  
Atmospheric Pollutants ◽  
World Health ◽  
European Region ◽  
Disease Rate ◽  
Regional Office ◽  
Environment And Health ◽  
Environmental Causes

EU countries have accumulated a considerable amount of scientific research demonstrating the influence of a number of environmental factors on human health. The paper reviews European research on the relation between the environment and human health. The authors present a review of normative and non-governmental initiatives in the field of environmental control and human health in the European region, major environmental causes of human health deterioration and initiatives aiming at preventing ecology-dependant health issues. In 1989 World Health Organisation (WHO) held the First Ministerial Conference on Environment and Health that kickstarted the process uniting the healthcare field and the field of environmental protection. The main objective of the “Environment and Health” Process is to mitigate major environmental risks for human health. The objective is to be achieved through regular Ministerial Conferences held every five years by the World Health Organisation Regional Office. According to the policy stated in “Health-2020”, ecology is an important factor for maintaining good human health and establishment of sustainable communities and favorable environment should be prioritized in the European region of WHO. According to the research presented by WHO, major environmental causes of increased disease rate are atmospheric pollutants, accumulation of heavy metal leads and other harmful chemicals in the environment, climate change, noise pollution, low quality of drinking water and poor hygienic conditions. The review presents a consideration of recommendations given in “Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement”, Scopus, Web of Science, eLIBRARY.RU, CyberLeninka, and other scientific databases were used for this review.

scholarly journals Development of Quality Management System Under ISO 9001:2015 and Joint Inspection Group (JIG) for Aviation Fuelling Service

2017 ◽  
Vol 8 (3) ◽  
pp. 50-59 ◽  
Author(s):  
Kanon Ruamchat ◽  
Natcha Thawesaengskulthai ◽  
Chaipong Pongpanich
Keyword(s):  
Quality Improvement ◽  
Quality Management ◽  
Management System ◽  
Distribution Systems ◽  
Management Practices ◽  
Quality Management System ◽  
Aviation Fuel ◽  
Iso 9001 ◽  
Fuel Quality ◽  
Petroleum Company

Abstract The Joint Inspection Group (JIG) standard for aviation fuel quality management assists in the operational process and maintenance of aviation fuel from its point of origin and through distribution systems to airports. Currently, problems arise as the JIG standard and quality management in aviation fuel are isolated and have independent procedures. Merging the JIG standards with ISO 9001:2015 can override original JIG’s philosophy by connecting all quality assessment, and management parties involved, throughout the supply chain. This integration can harmonize auditing tasks, focusing on risk/opportunity, and continue quality improvement focus. This paper proposes a development of quality management system (QMS) under ISO 9001:2015 for aviation fuelling service in a systematic way. The content and critical success factors of ISO 9001:2015 and JIG standards were studied. The beneficial synergies, similarities, and logical linkages between both standards are identified. This QMS was developed in the largest petroleum company in Thailand and 60 selected experts were surveyed, with a response rate of 88.3%, for their agreement on integrated criteria. Two external quality auditors, who have ISO 9001 and JIG expertise, were interviewed to modify our initial proposed QMS. The final QMS was implemented in the into-plane fuelling services as the first phase of this implementation. Results of framework implementation are discussed in a case study. There are mutual benefits resulting from the integration of JIG and ISO 9001:2015 standards. This QMS provides a unified process for quality management practices, and enhances the effectiveness of risk evaluation as well as the opportunity for continued quality improvement. It facilitates the identification of ISO 9001:2015 requirements and establishes relationships between the roles of JIG standard and the clauses of ISO 9001:2015. The first experience from five airports as the pilot study of proposed QMS implementation minimized conflicts and duplications between JIG and ISO 9001:2015 standards, reduced the number of into-plane fuelling service incidents reported, such as oil spill, machine stoppage, re-inspections, and recall costs.

scholarly journals HOW, WHY AND UNDER WHAT CIRCUMSTANCES DOES A QUALITY IMPROVEMENT COLLABORATIVE BUILD KNOWLEDGE AND SKILLS IN CLINICIANS WORKING WITH PEOPLE WITH DEMENTIA? A REALIST INFORMED PROCESS EVALUATION

2020 ◽  
Author(s):  
Lenore A de la Perrelle ◽  
Monica Cations ◽  
Gaery Barbery ◽  
Garjana Radisic ◽  
Billingsley Kaambwa ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Process Evaluation ◽  
World Health Organisation ◽  
Dementia Care ◽  
Program Theory ◽  
World Health ◽  
Quality Improvement Collaborative ◽  
Post Intervention ◽  
Knowledge And Skills ◽  
People With Dementia

In increasingly constrained health and aged care services, strategies are needed to improve quality and translate evidence into practice. In dementia care, recent failures in quality and safety have led the World Health Organisation to prioritise the translation of known evidence into practice. While quality improvement collaboratives have been widely used in healthcare, there are few examples in dementia care. We describe a recent quality improvement collaborative to improve dementia care across Australia and assess the implementation outcomes of acceptability and feasibility of this strategy to translate known evi-dence into practice. A realist-informed process evaluation was used to analyse how, why and under what circumstances a quality improvement collaborative built knowledge and skills in clinicians working in dementia care. This realist-informed process evaluation developed, tested, and refined the program theory of a quality improvement collaborative. Data were collected pre-and post-intervention using surveys and interviews with participants (n=24). A combined inductive and deductive data analysis process integrated three frameworks to examine the context and mechanisms of knowledge and skill building in participant clinicians. A refined program theory showed how and why clinicians built knowledge and skills in quality improvement in dementia care. Seven mechanisms were identified: motivation, accountability, identity, collective learning, credibility, and reflective practice. Each of these mechanisms operated differently according to context. A quality improvement collaborative designed for clinicians in different contexts and roles was acceptable and feasible in building knowledge and skills of clinicians to improve dementia care. A supportive setting and a credible, flexible, and collaborative process optimises quality improvement knowledge and skills in clinicians working with people with dementia.

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