title: The impact of SLMTA in improving laboratory quality systems in the Caribbean Region.
abstract: BACKGROUND
  Past efforts to improve laboratory quality systems and to achieve accreditation for better patient care in the Caribbean Region have been slow.
  
  
  OBJECTIVE
  To describe the impact of the Strengthening of Laboratory Management Toward Accreditation (SLMTA) training programme and mentorship amongst five clinical laboratories in the Caribbean after 18 months.
  
  
  METHODS
  Five national reference laboratories from four countries participated in the SLMTA programme that incorporated classroom teaching and implementation of improvement projects. Mentors were assigned to the laboratories to guide trainees on their improvement projects and to assist in the development of Quality Management Systems (QMS). Audits were conducted at baseline, six months, exit (at 12 months) and post-SLMTA (at 18 months) using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist to measure changes in implementation of the QMS during the period. At the end of each audit, a comprehensive implementation plan was developed in order to address gaps.
  
  
  RESULTS
  Baseline audit scores ranged from 19% to 52%, corresponding to 0 stars on the SLIPTA five-star scale. After 18 months, one laboratory reached four stars, two reached three stars and two reached two stars. There was a corresponding decrease in nonconformities and development of over 100 management and technical standard operating procedures in each of the five laboratories.
  
  
  CONCLUSIONS
  The tremendous improvement in these five Caribbean laboratories shows that SLMTA coupled with mentorship is an effective, user-friendly, flexible and customisable approach to the implementation of laboratory QMS. It is recommended that other laboratories in the region consider using the SLMTA training programme as they engage in quality systems improvement and preparation for accreditation.
authors.affiliation: US Centers for Disease Control and Prevention, Caribbean Regional Office, Barbados.
authors.forename: Giselle
authors.initials: G
authors.lastname: Guevara
authors.affiliation: African Field Epidemiology Network, Caribbean Office.
authors.forename: Floris
authors.initials: F
authors.lastname: Gordon
authors.affiliation: African Field Epidemiology Network, Caribbean Office.
authors.forename: Yvette
authors.initials: Y
authors.lastname: Irving
authors.affiliation: Princess Margaret Hospital, Bahamas.
authors.forename: Ismae
authors.initials: I
authors.lastname: Whyms
authors.affiliation: US Centers for Disease Control and Prevention, Caribbean Regional Office, Barbados.
authors.forename: Keith
authors.initials: K
authors.lastname: Parris
authors.affiliation: Ladymeade Reference Unit, Barbados.
authors.forename: Songee
authors.initials: S
authors.lastname: Beckles
authors.affiliation: Clinton Health Access Initiative, Botswana.
authors.forename: Talkmore
authors.initials: T
authors.lastname: Maruta
authors.affiliation: African Field Epidemiology Network, Uganda.
authors.forename: Nqobile
authors.initials: N
authors.lastname: Ndlovu
authors.affiliation: US Centers for Disease Control and Prevention, Caribbean Regional Office, Barbados.
authors.forename: Rachel
authors.initials: R
authors.lastname: Albalak
authors.affiliation: US Centers for Disease Control and Prevention, Caribbean Regional Office, Barbados.
authors.forename: George
authors.initials: G
authors.lastname: Alemnji