Self-assessment Approach to Laboratory Gap Analyses is Cost-Effective
Title
Using a Self-assessment Approach to Conducting Laboratory Gap-analyses in Resource- constrained Environments is Cost-effective, Motivational and a Strategic Competency Development Approach
Wendy Kitson-Piggott and Valerie Wilson
Caribbean Med Labs Foundation
Background
The Caribbean Med Labs Foundation (CMLF) is an indigenous Caribbean NGO established in 2008 to strengthen regional laboratory services. CMLF is implementing the laboratory component of a 5-yr (2011-2015) CARICOM-PANCAP Global Fund Project (GFR 9) in 16 countries, aimed at strengthening laboratory networks to support HIV/AIDS control programmes. Limited resources are available for achieving desired outcomes. Using a cost-effective approach to identify significant gaps in laboratory quality structures, systems, services and diagnostic capacity was a strategic first step in the process.
Method
Five tools were designed and circulated electronically to laboratory managers in 16 Project countries to conduct preliminary self-assessments in 2011. Tools assessed regulatory structures (95 queries); quality management systems (246 queries); diagnostic capacity (35 queries); HIV-related reference service capacity (59 queries) and biosafety infrastructures and practices (216 queries). Tools were returned electronically and information entered into a Microsoft Access database. Preliminary data analysis was conducted using both Microsoft Access and Excel and existing gaps identified. Validation of data was completed using observations, document reviews and staff interviews during short onsite visits during 2011-2012. Gap analysis findings were discussed with laboratory staff and decision-makers.
Results
Data was received from 12 countries (75%). On-site validations provided opportunities to improve QMS knowledge and understanding. Examples of existing capacity included – regulation (25%); quality management offices (8%); national quality managers (31%); laboratory networks (12%); adequate resources (63%); adequate blood supplies (50%); HIV testing policies and plans (37%); QMS plans (17%); internal audits (33%); inventory control (41%); adequate QMS training (8%); competency measurement (33%); safety guidelines (39%); safety inspections (31%).
Background
The Caribbean Med Labs Foundation (CMLF) is an indigenous Caribbean NGO established in 2008 to strengthen regional laboratory services. CMLF is implementing the laboratory component of a 5-yr (2011-2015) CARICOM-PANCAP Global Fund Project (GFR 9) in 16 countries, aimed at strengthening laboratory networks to support HIV/AIDS control programmes. Limited resources are available for achieving desired outcomes. Using a cost-effective approach to identify significant gaps in laboratory quality structures, systems, services and diagnostic capacity was a strategic first step in the process.
Method
Five tools were designed and circulated electronically to laboratory managers in 16 Project countries to conduct preliminary self-assessments in 2011. Tools assessed regulatory structures (95 queries); quality management systems (246 queries); diagnostic capacity (35 queries); HIV-related reference service capacity (59 queries) and biosafety infrastructures and practices (216 queries). Tools were returned electronically and information entered into a Microsoft Access database. Preliminary data analysis was conducted using both Microsoft Access and Excel and existing gaps identified. Validation of data was completed using observations, document reviews and staff interviews during short onsite visits during 2011-2012. Gap analysis findings were discussed with laboratory staff and decision-makers.
Results
Data was received from 12 countries (75%). On-site validations provided opportunities to improve QMS knowledge and understanding. Examples of existing capacity included – regulation (25%); quality management offices (8%); national quality managers (31%); laboratory networks (12%); adequate resources (63%); adequate blood supplies (50%); HIV testing policies and plans (37%); QMS plans (17%); internal audits (33%); inventory control (41%); adequate QMS training (8%); competency measurement (33%); safety guidelines (39%); safety inspections (31%).
Ms Piggott presented information from this study at the conference of the African Society for Laboratory Medicine ( ASLM ), in Cape Town, South Africa, in December, 2012.
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