Hybrid Mentorship of Medical Laboratories to Achieve ISO 15189:2012 Accreditation in Malawi: The University of Maryland Malawi Experience

Hannaniah Moyo; Sophia Osawe; Charles Nyangulu; Philemon Ndhlovu; Visopo Harawa; Oscar Divala; Malango Msukwa; Talishiea Croxton; Natalia Blanco; Dyson Mwandama; Memory Mkandawire; Elizabeth Kampira; Muluken Kaba; Alice Maida; Andrew F. Auld; Lindsay Kim; Reuben Mwenda; Howard Kress; James Kandulu; Thresa Sumani; Joseph Bitilinyu; Thokozani Kalua; Alash’le Abimiku

doi:10.9745/GHSP-D-24-00254

Key Findings

Combining virtual and on-site mentorship sessions and training can be an effective strategy to support laboratories seeking accreditation.
A reduced accreditation scope (number of test types) in the first stage of seeking accreditation can aid the accreditation process.
Continuous mentorship is key in the maintenance of accreditation.

Key Implication

Hybrid mentorship can be a potential strategy for achieving and maintaining accreditation at a reduced cost.

ABSTRACT

Introduction:

As part of a laboratory strengthening program in Malawi to achieve and maintain International Organization for Standardization (ISO) 15189 accreditation, we intended to mentor selected HIV molecular laboratories to achieve this accreditation. Due to the COVID-19 pandemic, mentorship pivoted to a hybrid model using an Internet-based approach and on-site mentorships. We describe the implementation of this strategy, successes, and challenges.

Methods:

We conducted weekly, 1-hour virtual mentorship sessions for the 5 initial laboratories (cohort 1) selected based on their Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) performance score of 3 or more stars. Laboratories presented updates and supporting documents electronically, and trainings were conducted virtually. In September 2020, when travel restrictions were relaxed, we initiated hybrid mentorships and audits for cohort 1 laboratories. The same hybrid approach was used to mentor 4 additional laboratories in cohort 2. We performed descriptive analysis, and the Wilcoxon signed-rank test was used to compare the training pre-and post-test scores.

Results:

Between March 2020 and May 2023, the team completed a total of 54 virtual mentorship sessions and 20 on-site visits across 9 laboratories. Overall, the team conducted 8 training sessions for 35 laboratory quality officers. Median score improvement (pre-test vs. post-test scores) was observed across individual trainings and across cohorts (P<.01). At the end of cohort 1, 4 of 5 (80%) laboratories were accredited. One laboratory that did not reach accreditation joined cohort 2. At the end of the mentoring period, all 5 cohort 2 laboratories were accredited.

Conclusions:

We demonstrated that using a hybrid mentorship model for accreditation was a successful strategy during the COVID-19 pandemic. For the first time in Malawi, this strategy resulted in accrediting 9 of the 10 HIV molecular laboratories in 3 years at a reduced cost. Continuous mentorship is key in the maintenance of accreditation.

Footnotes

↵* Co-first authors.

Received: May 7, 2024.
Accepted: October 22, 2024.
Published: December 20, 2024.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit https://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-24-00254

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