Work Update.. Making ISO standards FUN!

It’s been almost two years I’ve been in Tanzania. Quite unbelievable that amount of time has passed.  Before I left the UK during one of the pre-departure training courses some ex-volunteers talked to our group.  I remember one of them saying that “your worklife as a volunteer fluctuates –sometimes you are busy at work, sometimes you have nothing to do, sometimes you will have success, sometimes failures and sometimes it feels like you are not achieving anything, changing anything or helping anyone!  But in the last few months of your placement things will finally start happening but time will also speed up and you will feel that there is not enough time to do everything.. why didn’t all this happen 2 years ago?!”

Well, they were right! I’ve had all of the above, and now with only a few months to go before the end of my volunteer placement, work is super busy, but things are finally falling into place! here’s a update on what I’ve been doing.(I apologise if it’s a bit geeky and dull… but that’s my job!) 

In November last year, our laboratory was accepted (after some campaigning on my part) onto the SLMTA/SLIPTA programmes. SLMTA stands for Strengthening Laboratory Management Towards Accreditation and SLIPTA stands for Stepwise Quality Improvement Toward Laboratory Accreditation.  The programmes are devised by the World Health Organisation to improve the management and Quality Systems of laboratories in developing countries and it has been used in many African countries including Tanzania with good success.  The SLIPTA program aims to make laboratories compliant with international standards for the management and running of the laboratory (the ISO 15189 Standards for Medical Laboratories - For geeks, this is like ISO 9001/2 but for laboratories instead of companies).  This is a big step, as even the UK laboratories are only just adopting the ISO 15189 standards, so Nyangao hospital has a chance of being ahead of the UK, and accredited to an international level!

The ISO standards cover all aspects of a laboratory such as Management, Staffing, Equipment, Safety, Quality control, Documentation, Communication, Auditing, Reporting etc, and the aim is to improve quality and make every aspect of work and management traceable, justified and accountable.  

So, for the past 12 months or so I have been working with the laboratory management team to make sure we meet all these rigorous standards.  This has meant devising a complete Quality Management System and document control system; writing or updating over one hundred policies, procedures, forms and documents and training staff in these new systems.  It’s been hard work getting everything written, and sometimes even harder work getting the staff to adopt the new systems.  ISO standards are a pretty dull subject, and quite a foreign concept to many people, Tanzanians and Non-Tanzanians alike! 

And then James made a filing system.. and he was pleased.

It may seem like just creating a lot of paperwork and a little detached from actually helping patients, but when followed correctly, a Quality Management System helps reduce and prevent laboratory errors, reduce loss of service due to equipment failures or reagent stock outs, improve quality control, improve staff training and overall improves the quality of the laboratory so it can provide accurate, reliable and timely results for the patients we serve.

The SLMTA program also gives training courses to the laboratory management team as well as providing a mentor to come to the lab for a fortnight, three times a year to assist with the introduction of the Quality Management System.  We have just recieved our mentor visit which has meant even more work in the last few weeks implementing her suggestions.

  Inspections are performed every four to six months, and the lab is rated on a 5 star system according to how well we meet the ISO standards.  Our first inspection scored us zero stars, which was expected as it was the baseline assessment.  We have done a huge amount of work since then, and still have a huge amount to do before  the next inspection which will be in May, literally weeks before I am due to leave! It will be rewarding for all of the laboratory staff to receive at least one star, if not four or five!!

  What was it the ex-volunteer said?? …In the last few months of your placement things will finally start happening but time will also speed up and you will feel that there is not enough time to do everything.. why didn’t all this happen 2 years ago?!  ….. So true! And I just hope there is enough time left!

my office ( I need a notice board)

In other news…… finally, after 18 months of campaigning, pestering and begging, we’ve had air conditioning fitted in the lab!  My office is no longer like a sauna and I can sit at my desk and not be in a puddle of my own sweat just from moving the mouse. 

Now, where did I put that piece of paper?  What was the document number?  What version is it??