title: Measurement of improvement achieved by participation in international laboratory accreditation in sub-Saharan Africa: the Aga Khan University Hospital Nairobi experience.
abstract: OBJECTIVE
  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.
authors.affiliation: rodney.adam@aku.edu.
authors.forename: Edwin
authors.initials: E
authors.lastname: Kibet
authors.forename: Zahir
authors.initials: Z
authors.lastname: Moloo
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Ojwang
authors.forename: Shahin
authors.initials: S
authors.lastname: Sayed
authors.forename: Ann
authors.initials: A
authors.lastname: Mbuthia
authors.forename: Rodney D
authors.initials: RD
authors.lastname: Adam
mesh_terms: D000068:Accreditation / Q000592:standards*; D017954:Africa South of the Sahara; D006801:Humans; D007755:Laboratories, Hospital / Q000592:standards*; D059021:Laboratory Proficiency Testing / Q000379:methods*
keywords: ISO 15189:2007; Medical laboratory accreditation; Quality improvement; South Africa National Accreditation System; Sub-Saharan Africa; Three-phased model