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  • 1.
    Rusanganwa, Vincent
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Section of Virology. University of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda; Ministry of Health, Kigali, Rwanda.
    Gahutu, Jean Bosco
    University of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda.
    Evander, Magnus
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Section of Virology.
    Hurtig, Anna-Karin
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Clinical Referral Laboratory Personnel’s Perception of Challenges and Strategies for Sustaining the Laboratory Quality Management System: A Qualitative Study in Rwanda2019In: American Journal of Clinical Pathology, ISSN 0002-9173, E-ISSN 1943-7722Article in journal (Refereed)
    Abstract [en]

    Objectives: To explore challenges explaining the decrease in quality performance and suggest strategies to improve and sustain laboratory quality services.

    Methods: Twenty key informants’ interviews from laboratory personnel were conducted in five laboratories. Four had previously shown a decrease in quality performance. Interviews were transcribed verbatim and analyzed using inductive thematic analysis.

    Results: Two themes emerged: (1) insufficient coordination and follow-up system towards accreditation, where lack of coordination, follow-up, and audits explained the decrease in performance; (2) inadequate resource optimization, where insufficient knowledge in Laboratory Quality Management System (LQMS), ownership by laboratory workforce, and insufficient stakeholders’ communication contributed to low-quality performance.

    Conclusions: The coordination, follow-up, and assessments of LQMS, in conjunction with training of laboratory workforce, would establish an institutional culture of continuous quality improvement (CQI) towards accreditation and sustainment of quality health care. To achieve CQI culture, routine gap checking and planning for improvement using a system approach is required.

  • 2.
    Rusanganwa, Vincent
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Section of Virology.
    Gahutu, Jean Bosco
    Nzabahimana, Innocent
    Ngendakabaniga, Jean Marie Vianney
    Hurtig, Anna-Karin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Evander, Magnus
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Section of Virology.
    Clinical Referral Laboratories in Rwanda: The Status of Quality Improvement After 7 Years of the SLMTA Program2018In: American Journal of Clinical Pathology, ISSN 0002-9173, E-ISSN 1943-7722, Vol. 150, no 3, p. 240-245Article in journal (Refereed)
    Abstract [en]

    Objectives: We investigated the quality system performance in Rwandan referral laboratories to determine their progress toward accreditation.

    Methods: We conducted audits across five laboratories in 2017, using the Stepwise Laboratory Quality Improvement Process Towards Accreditation checklist. Laboratories were scored based on the World Health Organization grading scale (0-5 stars scale) and compared with earlier audits.

    Results: Between 2012 and 2017, only one laboratory progressed (from four to five stars). Four of the five laboratories decreased to one (three laboratories) and zero (one laboratory) stars from four and three stars. Management reviews, evaluation, audits, documents, records, and identification of nonconformities showed a low performance.

    Conclusions: Four of five laboratories are not moving toward accreditation. However, this target is still achievable by energizing responsibilities of stakeholders and monitoring and evaluation. This would be possible because of the ability that laboratories showed in earlier audits, coupled with existing health policy that enables sustainable quality health care in Rwanda.

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