Amsterdam 2015
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| Abstract #1003 - Poster 2 | ||||
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Session: 59.25: Poster 2 (Poster) on Tuesday in Chaired by Authors: Presenting Author: Dr Doumbouya Bangaly - ORFEE Côte d'Ivoire, Cote D'ivoire |
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| Additional Authors: | ||||
| Aim: Context Duékoué District Hospital is located in the west health region of Ivory Coast. It’s a 75 bed government hospital, that covers around 250 000 habitants. HIV-AIDS pediatric care is provided there since December 2007. Currently there are 29 exposed and infected children in care with 7 currently receiving HAART. A quality Improvement (QI) project has been conducted in this hospital by a multidisciplinary team. The baseline data (April 2013) reveal that only 5% of HIV exposed and infected children continued the care and treatment. So we sought to improve this measure through QI process. Objective Improve from 5% to 25%, the rate of HIV exposed and infected children who continued the care and treatment by March 2014. | ||||
| Method / Issue: Root problem Very low rate (5%) of HIV exposed and infected children who continued the care and treatment. Causes Analysis Brainstorming and Ishikawa diagram methods have been used to identify different causes by field: Staff/ patient: 1- Results of the PCR have not available in the established delays, 2- The mothers of exposed and infected children not have enough knowledge of care and treatment process for their children. Environnement: The mothers of exposed and infected children are living far from the site. Procedure: 1- Time to see doctor is so long 2- Results of PCR test not daily reported on SIGDEP database. Equipment: No machine to perform PCR test in the lab of the site. Strategies for changes - Motivation/ Engagement of Staff - Classification causes in order of importance (Pareto method) - Rigorous documentation of tested interventions - Sharing of results Interventions Different strategies tested/applied as Plan-Do-Study-Act (PDSA), concerning 3 issues: 1. The mothers of HIV exposed and infected children not have enough knowledge of care and treatment process for their children. 2. Results of the PCR have not available in the established delays. 3. Time to see doctor is so long for the HIV exposed and infected children. | ||||
| Results / Comments: Results Monthly report generated by SIGDEP database showed (April 2013 – march 2014) that rate for HIV exposed and infected children continued the care and treatment, has been increased from 5% to 37% in the period of quality performance assessment. | ||||
| Discussion: Effects of changes Parents of HIV exposed and infected children have recognized that it’s necessary to respect the appointment for periodic medical visits.Results of PCR are now regularly available in time.Lesson learntFinding the root causes of the problem is the backbone of successful improvement.Good coordination between different services is essential to quality of careMessages to othersSuccessful interventions should be adopted as routine activities for sustainability of improvement in care. Ensure continuity of care and treatment is crucial in delivering quality of services to HIV exposed and infected children. | ||||
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