Measurement of improvement achieved by participation in international laboratory accreditation in sub-Saharan Africa: the Aga Khan University Hospital Nairobi experience

Abstract

Objectives: As part of the ISO 15189:2007 accreditation process, the Aga Khan University Hospital Nairobi laboratory became the first internationally accredited hospital laboratory in sub-Saharan Africa outside South Africa in 2011 through the South Africa National Accreditation System.

Methods: Seven preanalytic, 10 analytic, eight postanalytic, and five administrative performance parameters were monitored from 2009 to 2012 to measure the impact of the accreditation process.

Results: Most measures in all four categories showed substantial improvement. The seven preanalytic measures all showed major improvement-between a quarter and a half sigma. Real but less dramatic improvement appeared in analytic and postanalytic measures, but greater than one sigma decrease in analytic "procedure violations" and a three-quarter sigma decrease in excessive turnaround time were noted in these categories. Administrative improvements included dramatic decreases in misdirected and missing reports and complaints.

Conclusions: This study demonstrates the correlation of the accreditation process with improvement in quality measures in a low-resource region.

Keywords: ISO 15189:2007; Medical laboratory accreditation; Quality improvement; South Africa National Accreditation System; Sub-Saharan Africa; Three-phased model.