Impact of mentorship on WHO-AFRO Strengthening Laboratory Quality Improvement Process Towards Accreditation (SLIPTA)

Abstract

BackgroundThe improvment of the quality of testing services in public laboratories is a high priority in many countries. Consequently, initiatives to train laboratory staff on quality management are being implemented, for example, the World Health Organization Regional Headquarters for Africa (WHO-AFRO) Strengthening Laboratory Management Towards Accreditation (SLMTA). Mentorship may be an effective way to augment these efforts.MethodsMentorship was implemented at four hospital laboratories in Lesotho, three districts and one central laboratory, between June 2009 and December 2010. The mentorship model that was implemented had the mentor fully embedded within the operations of each of the laboratories. It was delivered in a series of two mentoring engagements of six and four week initial and follow-up visits respectively. In total, each laboratory received 10 weeks mentorship that was separated by 6–8 weeks. Quality improvements were measured at baseline and at intervals during the mentorship using the WHO-AFRO Strengthening Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist and scoring system.ResultsAt the beginning of the mentorship, all laboratories were at the SLIPTA zero star rating. After the initial six weeks of mentorship, two of the three district laboratories had improved from zero to one (out of five) star although the difference between their baseline (107.7) and the end of the six weeks (136.3) average scores was not statistically significant (p = 0.25). After 10 weeks of mentorship there was a significant improvement in average scores (182.3; p = 0.034) with one laboratory achieving WHO-AFRO three out of a possible five star status and the two remaining laboratories achieving a two star status. At Queen Elizabeth II (QE II) Central Laboratory, the average baseline score was 44%, measured using a section-specific checklist. There was a significant improvement by five weeks (57.2%; p = 0.021).ConclusionThe mentorship programme in this study resulted in significant measurable improvements towards preparation for the WHO-AFRO SLIPTA process in less than six months. We recommend that mentorship be incorporated into laboratory quality improvement and management training programmes such as SLMTA, in order to accelerate the progress of laboratories towards achieving accreditation.

Setting up a structured laboratory mentoring programme

“…This facility-based and embedded approach to mentorship has been observed to have high impact in different settings. 4,5 …”

“…3 A culture of practicing quality routinely is a behaviour change issue and calls for a different approach to training. 4 The Foundation of Health survey indicated that approaches that utilise active learning strategies, where participants put quality improvement into practice through close coaching and mentoring, are thought to be more effective than didactic classroom styles alone. 1 …”

“…Anecdotal reports suggest that the laboratory side of healthcare has also been active in this area, but that most of the work remains undocumented. One successful model that has been documented is the Lesotho mentorship model 4 , where a facility based approach by an experienced mentor resulted in considerable transfer of quality management skills to the laboratory staff.…”

The SLMTA programme: Transforming the laboratory landscape in developing countries

“…31,32 At the time that SLMTA was adopted, the country had already begun a structured mentorship programme with an embedded mentor. This mentor soon became certified as a SLMTA trainer so that he could enhance on-going mentoring efforts with the SLMTA programme.…”

“…32,35 This model has welldefined goals for each mentoring engagement, extended contact time on site, defined periods when mentors are absent, consistent approaches across laboratories and measurement of progress using standardised tools. Mentors may come from the laboratories they are assigned to mentor, from a local partner, or from outside the country.…”