Evaluation of Laboratory Quality Management Practices in Government-Owned Hospitals in Enugu State

Laboratory quality management is critical to producing reliable diagnostic results that guide appropriate patient care, yet quality systems in government-owned hospital laboratories across Nigeria remain largely unevaluated. This descriptive cross-sectional study assessed laboratory quality management practices across 10 government-owned hospital laboratories in Enugu State, in the South East geopolitical zone of Nigeria. The WHO Laboratory Quality Stepwise Implementation (LQSI) tool was adapted as the assessment framework, covering quality management system essentials including personnel, equipment, processes, documents, information management, and external quality assurance. Laboratories were scored on a five-step maturity continuum. No laboratory assessed reached step 3 (intermediate) or above of the LQSI framework. Internal quality control practices were inconsistently applied in 80 percent of laboratories. Standard operating procedures were absent or outdated in 70 percent of facilities. Equipment maintenance logs were incomplete in 90 percent of cases. External quality assessment participation was documented in only 20 percent of assessed laboratories. Personnel reported no formal quality management training in 65 percent of facilities. These findings reveal alarming quality deficits in Enugu State hospital laboratories. The study recommends adoption of the LQSI stepwise improvement pathway, government funding for quality assurance programs, and mandatory medical laboratory scientist participation in external quality assessment schemes coordinated by the Medical Laboratory Science Council of Nigeria. Keywords: laboratory quality management, LQSI, Enugu, diagnostic quality, external quality assurance.