Quality improvement is a fundamental component of the delivery of HIV prevention and treatment services and aims to provide an in-depth evaluation of services and a pathway for improving them. Quality improvement includes regular measurement of processes and outcomes to analyze the performance of the system with the ultimate goal of reducing variation in service delivery by implementation of the most effective solutions. Quality improvement work in the HIV field is directed toward achieving better health outcomes such as effective linkage to care after diagnosis, retention in care, and HIV viral load suppression. Quality improvement activities can range from a single team focusing on improving one aspect of care to a comprehensive programme with many teams working on a wide variety of improvement projects with a well-established plan and an oversight committee.
Data quality assessment (DQA) is often embedded in quality improvement and used to guide the data quality improvement process. DQA determines which types of data need improvement and what the priorities are, and thus supports the accurate measurement of programme performance. High quality data are critical for monitoring programme effectiveness and making programmatic decisions as well as for ensuring a high quality of services.
The course will start with an outline of the principles of quality assessment and quality improvement. Presentations will firstly address activities that are central to improving data quality, such as data verification and assessment of the strategic information system that produces the data, and key issues that compromise data quality such as under- or over-reporting of services outputs and/or recipients, lack of comparability of results over time, etc. The course will then focus on activities associated with quality improvement of HIV services (grouped under the three broad categories of defining, measuring and improving quality), and give examples from HIV prevention and treatment programmes. The examples of quality improvement tools will include flowcharts, which help to visualize a process and identify potential sources of problems and solutions, and cause-and-effect diagrams (Ishikawa and fishbone diagrams). Finally, the course will describe ways in which HIV strategic information can be used for programme evaluation and development, in advocacy and resource mobilization, for academic purposes and in research, and how best to visualize data. Presentations will address methods such as data synthesis and the use of HIV care cascades to improve performance at facility and sub-national levels. Participants will be able to practice data visualization and designing the dashboards in Excel.
Participants will be given an opportunity to share their own country-specific experiences in HIV data quality and service quality assessment on the first day, and challenges that have been encountered.
The key part of the course a group or individual work on protocol development. Participants can work on the following topics:
- quality improvement of an HIV prevention or treatment programme
- quality improvement of a specific component of the HIV strategic information system (case-based surveillance, patient monitoring, HIV testing, ANC/PMTCT data monitoring, etc)
- data quality assessment and improvement
- data visualizations
The course consists of lectures, exercises and case studies. It is designed to provide participants with practical skills and knowledge in data and services quality assessment and data use.
Professionals working in HIV programme development, HIV surveillance and programme evaluation.
Course lecturers and facilitators:
- Professor George W. Rutherford, MD, Global Health Sciences, University of California, San Francisco, USA
- Associate professor Ivana Božicević, MD, MSc, DrPH, WHO Collaborating Centre for HIV Strategic Information, School of Medicine, University of Zagreb
- Zoran Dominković, WHO Collaborating Centre for HIV Strategic Information, School of Medicine, University of Zagreb
Lucija Šikić, WHO Collaborating Centre for HIV Strategic Information
The course is organized by:
WHO Collaborating Centre for HIV Strategic Information
Andrija Stampar School of Public Health
School of Medicine, University of Zagreb
10 000 Zagreb, Croatia
Phone: + 385 1 45 90 142/ 45 90 100
Fax: + 385 1 46 84 212