Article Text

Download PDFPDF
‘Mali Matters’: reflections on a leadership and quality improvement project to improve blood transfusion safety at Maluti Adventist Hospital, Mapoteng, Lesotho
  1. Charlotte M Snead1,
  2. Rebecca J Upton1,
  3. Gilbert S V N Ranaivoarijaona2,
  4. Ellen Luthango3
  1. 1 NHS Improving Global Health Programme, Southern Health NHS Foundation Trust, Southampton, UK
  2. 2 Internal Medicine, Maluti Adventist Hospital, Mapoteng, Lesotho
  3. 3 Quality Improvement Office, Maluti Adventist Hospital, Mapoteng, Lesotho
  1. Correspondence to Dr Charlotte M Snead, NHS Improving Global Health Programme, Southern Health NHS Foundation Trust, Southampton, UK; csnead{at}


Introduction This report outlines a quality improvement (QI) project aiming to improve blood transfusion safety at Maluti Adventist Hospital (MAH), Lesotho, from August 2019 to January 2020.

The project team comprised nine local staff members and two UK doctors working through the NHS ‘Improving Global Health through Leadership Development’ (IGH) programme.

Methods Baseline data was gathered and a ‘process mapping’ meeting held to understand existing processes and identify methods for improvement.

Improvements were implemented using Plan-Do-Study-Act (PDSA) methodology.

The NHS Healthcare Leadership Model was used as a framework for leadership development and team members reflected on their personal learning.

Results Varied interventions included introduction of a pre-transfusion bedside safety checklist and staff training.

Documentation of critical patient identifiers for transfusion improved. Completion of the bedside safety checklist was 65.5% by 3 months. Knowledge scores improved post-transfusion training. 77% of staff strongly agreed and 21% agreed that the training was useful.

Challenges and further work were reflected on.

Discussion This collaborative system-strengthening project provided varied, reciprocal learning experiences including skills in leadership, teamwork, teaching, QI methodology, communication and IT.

Our experiences will help to inform ongoing work at MAH and may be helpful to others conducting similar work in related settings.

  • clinical leadership
  • development
  • improvement
  • leadership assessment
  • patient safety

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors CMS, RJU, GSVNR and EL were all part of the QI committee involved in running the Mali Matters project. CMS was project lead. CMS and RJU wrote the introduction. CMS wrote the initial summary of the QI project. CMS, RJU, GSVNR and EL jointly wrote the reflections on reciprocal learning and leadership experience. CMS compiled the first draft of the overall report. RJU, GSVNR and EL reviewed and edited the first draft. CMS and RJU edited further versions of the drafts. GSVNR and EL reviewed subsequent drafts and all authors approved the final submitted version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.