Survey of Global Health Education and Training in Pathology Residency Programs in the United States.

OBJECTIVES: This study assessed the prevalence, general interest, and barriers to implementing global health curricula in pathology residency programs. METHODS: We conducted a survey of 166 US pathology residency programs. RESULTS: Thirty-two (195) of 166 programs responded. Of these, 13% have a formalized global health program (n = 4), and the majority indicated at least some general interest in global health among trainees (88%, n = 28) and faculty (94%, n = 30), albeit at a low to moderate level. Funding limitations, regulatory constraints, and insufficient knowledge of global health were frequently cited barriers to developing a global health program. CONCLUSIONS: Few US pathology departments incorporate global health education into postgraduate training. The importance of pathology in global health has been underappreciated, despite its critical role in the delivery of health care in resource-limited settings. One solution is for pathology departments to expand global health educational opportunities for trainees.

Strengthening Laboratory Management Toward Accreditation, A Model Program for Pathology Laboratory Improvement.

The Strengthening Laboratory Management Toward Accreditation (SLMTA) program and subsequent Stepwise Laboratory Quality Improvement Process Toward Accreditation (SLIPTA) checklist were a response to the need for high-quality laboratories to combat the human immunodeficiency virus (HIV) epidemic and provide patients with the highest-quality care. The two tools work together to create a culture of quality in laboratories and allow the identification of gaps. The ultimate goal for any laboratory is to achieve a standard benchmark for quality and these programs have been highly successful in initially affecting the HIV epidemic but continuously improving laboratory quality across all diseases.

Laboratory quality improvement in Tanzania.

OBJECTIVES: The article describes the implementation and improvement in the first groups of medical laboratories in Tanzania selected to participate in the training program on Strengthening Laboratory Management Toward Accreditation (SLMTA). METHODS: As in many other African nations, the selected improvement plan consisted of formalized hands-on training (SLMTA) that teaches the tasks and skills of laboratory management and provides the tools for implementation of best laboratory practice. Implementation of the improvements learned during training was verified before and after SLMTA with the World Health Organization African Region Stepwise Laboratory Improvement Process Towards Accreditation checklist. RESULTS: During a 4-year period, the selected laboratories described in this article demonstrated improvement with a range of 2% to 203% (cohort I) and 12% to 243% (cohort II) over baseline scores. CONCLUSIONS: The article describes the progress made in Tanzania's first cohorts, the obstacles encountered, and the lessons learned during the pilot and subsequent implementations.

One laboratory's progress toward accreditation in Tanzania.

INTRODUCTION: The Amana Regional Hospital Laboratory in Tanzania was selected, along with 11 other regional and district laboratories, to participate in a pilot programme for laboratory quality improvement using the Strengthening Laboratory Management Toward Accreditation (SLMTA) training programme. PROGRAMME IMPLEMENTATION: The SLMTA programme entailed hands-on learning, improvement projects between and after a three-workshop series, supervisory visits from an oversight team and an expert laboratory mentor to facilitate and coach the process. Audits were conducted at baseline, exit (approximately one year after baseline) and follow-up (seven months after exit) using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist. Quality stars (zero to five) were awarded based on audit scores. RESULTS: With a dedicated staff and strong leadership from laboratory management, Amana Laboratory implemented processes, policies and procedures recommended as elements of best laboratory practices. The laboratory improved from zero stars (36%) at baseline to successfully achieving three stars (81%) at exit. This was the highest score achieved by the 12 laboratories in the programme (the median exit score amongst the other laboratories was 58%). Seven months after completion of the programme, the laboratory regressed to one star (62%). DISCUSSION: As the SLMTA improvement programme progressed, Amana Laboratory's positive attitude and hard work prevailed. With the assistance of a mentor and the support of the facility's management a strong foundation of good practices was established. Although not all improvements were maintained after the conclusion of the programme and the laboratory dropped to a one-star rating, the laboratory remained at a higher level than most laboratories in the programme.