Friday, November 16, 2012

Attitude change and sustainability...

This morning I had a brief conversation with my colleagues about bringing in a lab technician from outside of Sierra Leone to help develop the lab at the hospital. The first questions asked was: How can you make sure that all that person has accomplished is sustained once they leave again? Now that is the million dollar question. The simple answer is: I can't be sure.

I think that there are a number of factors contributing to the suboptimal lab services at our hospital. Think of training, availability of consumables, systems for writing/reporting/distributing results, motivation, equipment issues, etc. Personally, I think our lab has a lot of potential, even with its somewhat limited resources. I think that part of the problem is the lack of systems in place - for requisition of consumables, accountability of staff showing up to work, getting results back to the patients etc. Some of the systems really aren't in place, others are in place but ineffective and others are in place but people aren't motivate to use the proper channels. I actually think a lot of this comes down to staff attitude and motivation. I believe if you are motivated, you can get so much more done. If a system doesn't exist, you build it. If it doesn't function, you try to improve it. 

I think that we have reached the point that some long-term help would be beneficial but I agree we have to make sure this makes a big impact while that person is at the hospital which will continue once they've left. I would hope that this person could provide the hands on training needed not only to improve the efficiency and quality of the laboratory tests and put systems in place, but also to motivate people and get people excited about their job. To get technicians to realize that they are not just working with specimens, they are working with patients. Children who need a proper diagnosis in order to receive appropriate treatment. That's what we need to try to get across to them. And if we can get their minds thinking in that way, maybe sustaining good practice won't be so hard when outside help has come and gone. What do you think?

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