A key USAID/SUSTAIN objective is to enhance the quality of comprehensive HIV care and treatment, prevention of mother-to-child transmission of HIV (PMTCT) and tuberculosis (TB)/HIV services at project-supported hospitals. Currently, the project supports continuous quality improvement (CQI) activities at 14 out of the 18 supported hospitals.
SUSTAIN is utilizing the science of quality improvement (QI) to enhance provider performance. Using QI methodology, the project is equipping hospitals to change their systems and create more efficient and effective service delivery processes.
SUSTAIN’s QI work is being done in collaboration with the Ministry of Health (MOH) Quality Assurance Department and the USAID-funded Applying Science to Strengthen and Improve Systems (ASSIST) project. The work is guided by the Uganda Health Sector Quality Improvement Framework and Strategic Plan (2010/11 - 2014/15).
The fundamental concept underlying QI is that a system left unchanged can only be expected to continue to produce the same results it has been achieving. To achieve a new level of performance, it is essential to change the system. QI methodology requires the development of changes in processes and systems of health care delivery in ways that enable the implementation of high-impact, evidence-based interventions. It also identifies unnecessary, redundant or incorrect parts of processes and then changes them to yield streamlined and efficient care delivery.
To implement QI methodology, SUSTAIN is working with teams of healthcare workers to propose, test and measure the results of changes that may lead to systematic improvements. The project then supports hospital teams to share results, promoting the spread of changes that are proven to be effective. Thus, QI improves the effectiveness, efficiency and safety of HIV care and treatment service delivery.
Quality Improvement Results
SUSTAIN, in close coordination with the MOH Quality Assurance Department and the ASSIST project, has established QI teams within the supported health facilities to work and learn together to rapidly achieve significant improvements in the following areas:
- HIV testing and counselling
- Anti-retroviral therapy
- Prevention of mother-to-child transmission of HIV
- Laboratory services
- Pediatric HIV care and treatment
- Pharmaceutical logistics management systems