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WEPDD0105

WEPDD0105. Improving quality of care through provincial wide capacity building Dam Van Huong 1 , Thai Q. Nguyen 2 , Ho Thanh Huyen 1 , Todd Pollack* 2,3 , Phuong Do 2 , Howard Libman 2,3 , Lisa R. Hirschhorn 4,5,6 , Lisa A. Cosimi 2,3,6 .

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WEPDD0105

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  1. WEPDD0105 Improving quality of care through provincial wide capacity buildingDam Van Huong1, Thai Q. Nguyen2, Ho Thanh Huyen1, Todd Pollack*2,3, Phuong Do2, Howard Libman2,3, Lisa R. Hirschhorn4,5,6, Lisa A. Cosimi2,3,6 1Son La Provincial Health Center for HIV/AIDS Control, 2 Harvard Medical School AIDS Initiative in Vietnam, 3 Beth Israel Deaconess Medical Center, 4John Snow Institute, Inc., 5 Harvard Medical School, 6Brigham and Women’s Hospital

  2. Background • A sustainable response to the HIV epidemic requires: • a trained workforce across the cascade of care • systems to support effective care delivery • programs able to measure and improve quality and outcomes • In many countries early ART scale up has been supported by intensive onsite clinical mentoring and supervision. • Limitations: • costly, human resource intensive • often does not address systems-level quality issues • sustainability threatened by HCW turnover Goals: 1) Describe change in quality after addition of QI mentoring to traditional training and clinical mentoring. 2) Demonstrate feasibility and effectiveness of supporting local mentors to provide combined QI and clinical mentoring at HIV clinics in a rural province of Vietnam.

  3. Model Methods Training and mentorship from HAIVN staff • Data from routine PM analyzed for change from baseline across 8 core indicators: • Receipt of cotrimoxazoleif eligible • TB screening • Adherence screening • CD4 & routine labs done in last 6 months • ART started within 30 days of eligibility • % of patients with missed or late visit in last 6 months • Outreach by clinic staff for missed visits Provincial health department Provincial HIV doctors Clinical training and mentoring QI Training and mentoring District HIV Clinics

  4. Results Quality of care in Son La Provincial hospital at baseline and 12 months after implementing QI training and mentoring Improved quality seen across 7 HIV clinics after implementing combined approach of clinical training, mentoring and QI coaching

  5. Conclusions The addition of teaching and coaching in methods of QI adds to clinical mentoring in improving quality of care. Developing capacity of existing provincial staff to provide both clinical mentoring and QI coaching is a viable model to ensure and sustain quality HIV care services in a rural decentralized setting This approach may help improve the impact, outcome and sustainability of HIV health care worker strengthening efforts

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