Difference between revisions of "Journal:Developing a customized approach for strengthening tuberculosis laboratory quality management systems toward accreditation"

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==Introduction==
==Introduction==
The World Health Organization’s (WHO) End TB Strategy calls for an end to the global tuberculosis epidemic. It aims to reduce deaths by 95 percent and new tuberculosis cases by 90 percent, and also ensure that no family is burdened with catastrophic expenses due to tuberculosis by 2025.<ref name="WHOGlobal15">{{cite web |url=http://who.int/tb/post2015_strategy/en/ |title=WHO End TB Strategy: Global strategy and targets for tuberculosis prevention, care and control after 2015 |author=World Health Organization |date=2015 |accessdate=22 August 2016}}</ref> Despite the fall in global tuberculosis mortality by 47 percent since 1990, the disease still claimed more than 1.5 million lives in 2014.<ref name="WHOGlobalTub15">{{cite web |url=http://apps.who.int/iris/bitstream/10665/191102/1/9789241565059_eng.pdf |format=PDF |title=Global Tuberculosis Report 2015 |author=World Health Organization |date=2015 |isbn=9789241565059 |accessdate=22 August 2016}}</ref> A cascade of events — including poor screening, failure to link screened patients to diagnostic services, and failure to link diagnosed patients to treatment — means that many people die from tuberculosis due to delayed diagnosis and treatment initiation.<ref name="KuznetsovTwo14">{{cite journal |title=Two vicious circles contributing to a diagnostic delay for tuberculosis patients in Arkhangelsk |journal=Emerging Health Threats Journal |author=Kuznetsov, V.N.; Grjibovski, A.M.; Mariandyshev, A.O. et al. |volume=7 |pages=24909 |year=2014 |doi=10.3402/ehtj.v7.24909 |pmid=25163673 |pmc=PMC4147085}}</ref>
Quality-assured laboratory services are critical for the provision of timely, accurate, and reliable results to support diagnosis, drug-resistance testing, treatment monitoring, and surveillance of disease. Weak laboratory systems result in high levels of laboratory error that impact patient care and undermine the confidence healthcare providers have in laboratory services.<ref name="AlemnjiStrengthen14">{{cite journal |title=Strengthening national health laboratories in sub-Saharan Africa: a decade of remarkable progress |journal=Tropical Medicine & International Health |author=Alemnji, G.A.; Zeh, C.; Yao, K.; Fonjungo, P.N. |volume=19 |issue=4 |pages=450-8 |year=2014 |doi=10.1111/tmi.12269 |pmid=24506521 |pmc=PMC4826025}}</ref> In recent years, the focus on improving laboratory quality management systems (QMS), and assuring the quality of laboratory services by working toward national or international laboratory accreditation, has intensified.<ref name="Gershy-DametTheWorld10">{{cite journal |title=The World Health Organization African region laboratory accreditation process: Improving the quality of laboratory systems in the African region |journal=American Journal of Clinical Pathology |author=Gershy-Damet, G.M.; Rotz, P.; Cross, D. et al. |volume=134 |issue=3 |pages=393-400 |year=2010 |doi=10.1309/AJCPTUUC2V1WJQBM |pmid=20716795}}</ref> Accreditation is the formal recognition of implementation of a QMS that adheres to international standards and has been shown to improve the quality of healthcare for patients through reduction in testing errors.<ref name="PeterImpact10">{{cite journal |title=Impact of laboratory accreditation on patient care and the health system |journal=American Journal of Clinical Pathology |author=Peter, T.F.; Rotz, P.D.; Blair, D.H. et al. |volume=134 |issue=4 |pages=550-5 |year=2010 |doi=10.1309/AJCPH1SKQ1HNWGHF |pmid=20855635}}</ref>


==References==
==References==

Revision as of 21:10, 15 January 2018

Full article title Developing a customized approach for strengthening tuberculosis laboratory quality management systems toward accreditation
Journal African Journal of Laboratory Medicine
Author(s) Albert, Heidi; Trollip, Andre; Erni, Donatelle; Kao, Kekeletso
Author affiliation(s) Foundation for Innovative New Diagnostics
Primary contact Email: heidi dot albert at finddx dot org
Year published 2017
Volume and issue 6 (2)
Page(s) a576
DOI 10.4102/ajlm.v6i2.576
ISSN 2225-2010
Distribution license Creative Commons Attribution 2.0 Generic
Website http://www.ajlmonline.org/index.php/ajlm/article/view/576/826
Download http://www.ajlmonline.org/index.php/ajlm/article/viewFile/576/816 (PDF)

Abstract

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) program 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) program.

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 program 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 learned from early implementation of TB SLMTA suggest that a structured training and mentoring program can build a foundation towards further quality improvement in tuberculosis laboratories. Structured mentoring, and institutionalization of QMS into country programs, is needed to support tuberculosis laboratories to achieve accreditation.

Introduction

The World Health Organization’s (WHO) End TB Strategy calls for an end to the global tuberculosis epidemic. It aims to reduce deaths by 95 percent and new tuberculosis cases by 90 percent, and also ensure that no family is burdened with catastrophic expenses due to tuberculosis by 2025.[1] Despite the fall in global tuberculosis mortality by 47 percent since 1990, the disease still claimed more than 1.5 million lives in 2014.[2] A cascade of events — including poor screening, failure to link screened patients to diagnostic services, and failure to link diagnosed patients to treatment — means that many people die from tuberculosis due to delayed diagnosis and treatment initiation.[3]

Quality-assured laboratory services are critical for the provision of timely, accurate, and reliable results to support diagnosis, drug-resistance testing, treatment monitoring, and surveillance of disease. Weak laboratory systems result in high levels of laboratory error that impact patient care and undermine the confidence healthcare providers have in laboratory services.[4] In recent years, the focus on improving laboratory quality management systems (QMS), and assuring the quality of laboratory services by working toward national or international laboratory accreditation, has intensified.[5] Accreditation is the formal recognition of implementation of a QMS that adheres to international standards and has been shown to improve the quality of healthcare for patients through reduction in testing errors.[6]


References

  1. World Health Organization (2015). "WHO End TB Strategy: Global strategy and targets for tuberculosis prevention, care and control after 2015". http://who.int/tb/post2015_strategy/en/. Retrieved 22 August 2016. 
  2. World Health Organization (2015). "Global Tuberculosis Report 2015" (PDF). ISBN 9789241565059. http://apps.who.int/iris/bitstream/10665/191102/1/9789241565059_eng.pdf. Retrieved 22 August 2016. 
  3. Kuznetsov, V.N.; Grjibovski, A.M.; Mariandyshev, A.O. et al. (2014). "Two vicious circles contributing to a diagnostic delay for tuberculosis patients in Arkhangelsk". Emerging Health Threats Journal 7: 24909. doi:10.3402/ehtj.v7.24909. PMC PMC4147085. PMID 25163673. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4147085. 
  4. Alemnji, G.A.; Zeh, C.; Yao, K.; Fonjungo, P.N. (2014). "Strengthening national health laboratories in sub-Saharan Africa: a decade of remarkable progress". Tropical Medicine & International Health 19 (4): 450-8. doi:10.1111/tmi.12269. PMC PMC4826025. PMID 24506521. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4826025. 
  5. Gershy-Damet, G.M.; Rotz, P.; Cross, D. et al. (2010). "The World Health Organization African region laboratory accreditation process: Improving the quality of laboratory systems in the African region". American Journal of Clinical Pathology 134 (3): 393-400. doi:10.1309/AJCPTUUC2V1WJQBM. PMID 20716795. 
  6. Peter, T.F.; Rotz, P.D.; Blair, D.H. et al. (2010). "Impact of laboratory accreditation on patient care and the health system". American Journal of Clinical Pathology 134 (4): 550-5. doi:10.1309/AJCPH1SKQ1HNWGHF. PMID 20855635. 

Notes

This presentation is faithful to the original, with only a few minor changes to grammar, spelling, and presentation, including the addition of PMCID and DOI when they were missing from the original reference.