Cambodia Journal of Public Health (CJPH) of the School of Public Health at NIPH

Vanny You^1*, Chhorvann Chhea²

1. Laboratory Quality Management System (LQMS, NIPH; 2. National Institute of Public Health

ABSTRACT

Introduction

Laboratory Quality Management System (LQMS) training program was implemented in Cambodia in 2011 under the coordination of National Institute of Public Health (NIPH) and the Bureau of Medical Laboratory Services (BMLS), Hospital Department, Ministry of Health. LQMS training program has been contextualized from a program called “Strengthening Laboratory Management Towards Accreditation” (SLMTA) which intended to improve the quality management in clinical laboratories. This study aims to evaluate the effectiveness of the LQMS training program in 24 laboratories in public hospitals in Cambodia between 2011 and 2020.

Methods

Quality of the laboratory was assessed in percentage point using assessment tool which consists of twelve quality principles based on ISO 15189 requirements. The effectiveness of LQMS program was evaluated by comparing the assessment score (percentage point) before and after participating in LQMS program (using paired t-test) and between laboratories with and without LQMS training (using t-test). Linear regression was used to identify factors associated with the quality improvement of the LQMS group.

Results

Considerable quality improvement was observed at the laboratories after completing LQMS program (before LQMS=18.5% vs after LQMS=64.1%, p-value < 0.001). The laboratories with LQMS had significantly higher score than those absence of LQMS implementation, (11.4% vs 63.7%, p-value <0.001). Results showed that the most recent batches of LQMS training program have positive correlation with the laboratory quality improvement while smaller number of onsite mentoring in laboratory can make more improvement in lab quality management. However, being a laboratory of higher level (provincial level), and applying Laboratory Information System (LIS) did not affect quality of lab management system. There were 4 sections of the LQMS components which remained big gaps in the QMS implementation: management reviews, internal audits, non-conformity managements, and incidence managements.

Conclusions

After nearly a decade of LQMS implementation in Cambodia at 24 laboratories, their quality has been improved significantly. Further scale-up is needed to expand the LQMS program to other laboratories in response to the need for quality improvement of health services in Cambodia.