XVIII International AIDS Conference


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Continuous quality improvement (CQI) demonstrates improved delivery of HIV care and treatment in Guyana

Presented by Nicole Jordan (Guyana).

N. Jordan, J. Underwood

University of Medicine and Dentistry of New Jersey, School of Nursing: Francois-Xavier Bagnoud Center, Georgetown, Guyana

Background: In 2007, a Continuous Quality Improvement (CQI) program was implemented at 12 high volume outpatient service outlets to monitor the quality of HIV care delivered. Performance of key indicators for baseline and follow-up care in the preceding 12-month period was tracked through quarterly audits of randomly selected eligible patient records.
Methods: Audits were conducted in July 2007: 341 of 2105 charts (58.7% females; 69.8% on HAART), September 2008: 394 of 2320 charts (58.7% females; 56.7% on HAART); and September 2009: 522 of 2719 charts (58.8% females; 60.3% on HAART).
In addition, patients who received a physical examination at the most recent visit improved from 98.2% to 100%; patients whose adherence was assessed at each visit (HAART) improved from 93.4% to 99.6%; and patients with increased CD4+ count (HAART) improved from 78.6% to 96.7%.
Conclusions: CQI can result in improved and/or sustained delivery of services. CQI should be marketed as a non-punitive system of performance assessment and improvement. In 2009, with support from HIVQUAL International, indicators for outpatient HIV and HIV-TB care were streamlined and indicators for inpatient HIV and TB-HIV care and well child care were implemented, constituting a national CQI program known as HealthQUAL Guyana.

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