Abstract:
Background: Bungoma District Hospital Laboratory (BDHL), which supports a 200-bed
referral facility, began its Strengthening Laboratory Management Toward Accreditation
(SLMTA) journey in 2011 together with eight other laboratories in the second round of SLMTA
rollout in Kenya.
Objectives: To describe how the SLMTA programme and enhanced quality interventions
changed the culture and management style at BDHL and instilled a quality system designed
to sustain progress for years to come.
Methods: SLMTA implementation followed the standard three-workshop series, mentorship
site visits and audits. In order to build sustainability of progress, BDHL integrated quality
improvement processes into its daily operations. The lab undertook a process of changing its
internal culture to align all hospital stakeholders – including upper management, clinicians,
laboratory staff and maintenance staff – to the mission of sustainable quality practices at BDHL.
Results: After 16 months in the SLMTA programme, BDHL improved from zero stars (38%)
to four stars (89%). Over a period of two to three years, external quality assessment results
improved from 47% to 87%; staff punctuality increased from 49% to 82%; clinician complaints
decreased from 83% to 16; rejection rates decreased from 12% to 3%; and annual equipment
repairs decreased from 40 to 15. Twelve months later the laboratory scored three stars (81%) in
an external surveillance audit conducted by Kenya Accreditation Service (KENAS).
Conclusion: Management buy-in, staff participation, use of progress-monitoring tools and
feedback systems, as well as incorporation of improvement processes into routine daily
activities, were vital in developing and sustaining a culture of quality improvement.
