Implementation research: a mentoring programme to improve laboratory quality in Cambodia

Perrone, Lucy A.; Voeurng, Vireak; Sek, Sophat; Song, Sophanna; Vong, Nora; Tous, Chansamrach; Flandin, Jean-Frederic; Confer, D; Costa, Alexandre; Martin, Robert K.

doi:10.2471/blt.15.163824

Cited by 18 publications

(33 citation statements)

References 25 publications

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“…In 2016, Peronne et al . published results of using the LQSI tool, adapted into a spreadsheet‐based checklist and used in combination with training and regular onsite mentoring of laboratories in Cambodia . This project showed promising results, with improvements observed in timeliness, accuracy and reliability of services of hospital laboratories.…”

Section: Resultsmentioning

confidence: 99%

“…Although the LQSI tool is being disseminated in various laboratory strengthening initiatives worldwide, little evidence exists on its effects on laboratory improvement. In 2016, Peronne et al published results of using the LQSI tool, adapted into a spreadsheet-based checklist and used in combination with training and regular onsite mentoring of laboratories in Cambodia [9]. This project showed promising results, with improvements observed in timeliness, accuracy and reliability of services of hospital laboratories.…”

Section: Purpose and Structure Of The Lqsi Toolmentioning

confidence: 99%

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Evaluation of the WHO laboratory quality stepwise implementation tool

Datema

Roper

Cognat

et al. 2018

Tropical Med Int Health

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Section: Resultsmentioning

confidence: 99%

Section: Purpose and Structure Of The Lqsi Toolmentioning

confidence: 99%

Evaluation of the WHO laboratory quality stepwise implementation tool

Datema

Roper

Cognat

et al. 2018

Tropical Med Int Health

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“…However, while this may be a priority with the country's national health system, and an affirmation of the program's success, it is a drain to the public health laboratory systems that were targeted in the initial FELTP programs, reducing the number of highly qualified staff within laboratories. There are other laboratory training programs aiming at building competencies in laboratory quality management, or management and leadership, but these are mainly short term, specific program-oriented and often times aim for facility-based improvements, rather than national systems strengthening ( 19 , 20 ).…”

Section: Discussionmentioning

confidence: 99%

Field Epidemiology and Laboratory Training Program, Where Is the L-Track?

Gatei

Galgalo

Abade

et al. 2018

Front. Public Health

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Background: Modifications of the Field Epidemiology Training Program (FETP) curricula to include a laboratory track (L-Track), to become Field Epidemiology and Laboratory Training Program (FELTP), began in 2004 in Kenya. The L-Track offered candidates training on laboratory competencies in management, policy, quality systems, and diagnostic methods as well as epidemiology, disease surveillance and outbreak response. Since then several FELTPs have discontinued the L-Track and instead offer all candidates, epidemiologists and laboratorians, a single FETP curriculum. Reasons for these changes are reported here.Methods: A questionnaire was sent to directors of 13 FELTP programs collecting information on the status of the programs, reasons for any changes, basic entry qualifications, source institutions and where residents were post enrollment or after graduation. Data from previous CDC internal assessments on FELTP L-Track was also reviewed.Results: Out of the 13 FELTPs included, directors from 10 FELTPs sent back information on their specific programs. The FELTPs in Kenya, Mozambique, Cameroon and Kazakhstan and Mali have discontinued a separate L-Track while those in Ghana, Georgia, Nigeria, Rwanda, and Tanzania continue to offer the separate L-Track. Reasons for discontinuation included lack of standardized curriculum, unclear strategies of the separate L-Track, and funding constraints. Two countries Kenya and Tanzania reported on the career progression of their graduates. Results show 84% (Kenya) and 51% (Tanzania) of candidates in the FELTP, L-Track were recruited from national/regional medical health laboratories. However post-graduation, 56% (Kenya) and 43% (Tanzania) were working as epidemiologists, program managers, program coordinators, or regulatory/inspection boards. Professional upward mobility was high; 87% (Kenya) and 73% (Tanzania) residents, reported promotions either in the same or in new institutions.Conclusions: The FELTP L-Track residents continue to offer critical contributions to public health workforce development with high upward mobility. While this may be a reflection of professional versatility and demand of the FELTP graduates, the move from core laboratory services underscores the challenges in filling and retaining qualified staff within the laboratory systems. Results suggest different strategies are needed to strengthen laboratory management and leadership programs with a clear focus on laboratory systems and laboratory networks to meet current and future clinical and public health laboratory workforce demands.

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“…This revealed gaps in the areas of LQMS and workforce capacity, and additional investments in these areas were recommended to the Ministry of Health (MoH) [ 8 ]. The International Training and Education Center for Health (I-TECH) supported the Cambodia MoH Bureau of Medical Laboratory Services (BMLS) to implement a mentored LQMS strengthening program for 12 national and provincial hospital laboratories to improve quality management practices [ 9 , 10 ]. The training and mentoring program presented in this case study began in July 2017 and included a package of practice-based in situ LQMS education and training activities, on-site mentorship, and frequent remote tele-mentoring support to all 12 laboratories.…”

Section: Introductionmentioning

confidence: 99%

Strengthening the clinical laboratory workforce in Cambodia: a case study of a mixed-method in-service training program to improve laboratory quality management system oversight

Ong¹,

Donovan

Ndefru

et al. 2020

Hum Resour Health

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Background Laboratory diagnostic testing service delivery and compliance with international standards for laboratory quality are directly influenced by laboratory workforce competency. Many hospital laboratories in constrained resource settings such as Cambodia struggle to cope with the training needs of laboratory professionals in an environment of competing healthcare development priorities. Resource-limited countries need an adaptable and effective approach to provide laboratory professionals with job-specific quality oversight training to ensure the accuracy, timeliness, and reliability of diagnostic services. Case presentation Here, we describe the results of an in-service training and mentoring program conducted with the Cambodia Ministry of Health at 12 tertiary-level hospital laboratories to drive improvements in laboratory quality management systems toward ISO 15189 accreditation, which demonstrated significant progress between baseline and outcome audits in a concurrent study. This case study describes the program, and evaluates how the four primary activities, including actionable gap assessments and planning, centralized and in situ training curriculum, in-person mentoring, and remote tele-mentoring via video communication technologies, contributed towards quality improvement in the participating laboratories. We evaluated participant responses to Likert scale and free response questions from program and training evaluation surveys, and we used thematic analysis to develop a model of best practices within the program’s four primary activities to inform future training approaches. Of these activities, participants agreed most highly that in-person visits and planning based on gap assessments contributed to their learning and ability to improve laboratory operations. Tele-mentoring was rated lowest by participants, who were critical of excessive group dialogue and distraction during web-conferencing; however, feedback suggests both in-person and remote mentoring contribute to continuing education, accountability to action, and peer collaboration and problem solving to improve workforce efforts toward improved quality management systems. Conclusions We recommend here a package of in-service training activities for laboratory quality management system improvement initiatives in resource constrained settings that includes needs-based curricula and personalized action plans for participants; interactive and on-site training workshops; and in-person mentoring, complemented with well managed and regular tele-mentoring that focuses on knowledge retention, accountability to goals, and collaborative problem solving. Our model presents an adaptable approach to human resource development for quality improvement in medical laboratories.

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Implementation research: a mentoring programme to improve laboratory quality in Cambodia

Cited by 18 publications

References 25 publications

Evaluation of the WHO laboratory quality stepwise implementation tool

Evaluation of the WHO laboratory quality stepwise implementation tool

Field Epidemiology and Laboratory Training Program, Where Is the L-Track?

Strengthening the clinical laboratory workforce in Cambodia: a case study of a mixed-method in-service training program to improve laboratory quality management system oversight

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