The East African Public Health Laboratory Networking Project Overview of facility major achievements, challenges, key lessons FACILITY : MULAGO NATIONAL REFERRAL HOSPITAL (MNRH), CLINICAL LABORATORIES KAMPALA – UGANDA The East African Public Health Laboratory Networking Project Mrs Aisu Jessicah S Nabboiga Laboratory Manager

Presentation outline Background Major project activities at the site Major achievements in the project implementation Key lessons Challenges Way forward

Mulago National Referral Hosp Largest referral hospital in Uganda; specialized services Tertiary Teaching facilities, Located Kampala Founded in 1913 and completed in 1962 1,800 bed capacity Daily out patient attendance: 2,500 162,690 lab tests/month (average) 100 lab staff at facility

Map of Uganda

Mulago Hospital Complex

Regional peer assessment (2011-2017)

Accomplishments made using project funds Procurements made e.g. Photocopier, colored printer, computers Pharmaceutical fridge Big Volume Autoclave Genexpert Equipment Refrigerated Centrifuge Environmental monitoring equipment Safety gear Haematology EQA panel; RCPA Stationery

Cont’d Trained/ sensitized staff at site Maintained Data Clerks Biosafety/safe waste management Sensitized clinicians Fire drills ICT training Maintained Data Clerks

Major achievements at the facility as a result of project implementation Staff involvement/ownership of project 70% 8 trained in internal auditors. Continual reviews of manuals & SOPs Regular management review meetings, internal audits Reduction in number of rejected specimens in labs (by 40%) Reduction in number of non conformities General hospital is now training other departmental staff with aim of certifying others hospital units, the lab is being used as a role model in this institutional venture because of experience and strides in quality implementation

Major achievements Cont’d Increased hospital management support TAT for most tests reduced by 30% Participation in EQA testing (REQAS, RCPA)

Form a team & work as a team: they’ll own it Key Lessons Form a team & work as a team: they’ll own it Plan, implement planned activities together Funding makes a difference Document every process Lobby & obtain mgt support/commitment Quality is achievable but at a cost: there is need to invest

Major challenges Low budget Lab data management systems: largely manual Central labs currently under renovation, relocated to improvised space Fragmentation of the central Labs and the staff Storage of Equipment because of the improvised space Equipment maintenance; reagent stock outs

Way Forward Continuous involvement of all staff in quality improvement process. Continue to solicit mgt involvement & commitment Apply to SANAS for ISO Accreditation by September, 2017 Cascade QMS to the remaining network of labs in Mulago

Quotes “My child’s life was saved when the results came back quickly from the labs and the doctor was able to treat him” said a mother attending to her recovering baby boy “The clinicians’ handbook is spot on”! (intern doc). “Now give us IT & we receive test results on-line” (SHO)

Mulago Clinical Lab Mgt Team Photos of DED, LAB SUP, HOL, QO

Acknowledgements MOH/UNHLS ECSA-HC EAPHLNP Mulago NRH Management Mulago Lab Management & Staff MJAP Mentors

Thank you Murakoze Asante Sana