HIVQUAL-T Pediatric Program Plans for National Level Expansion and Scale-Up
December, 2008Pediatric HIVQUAL-T began in 2006 with 5 pilot sites at tertiary care hospitals in Thailand. Support was provided by CDC-GAP, and in 2007 the program was expanded to 12 sites, with additional key involvement and support from the Thai Ministry of Public Health (MOPH).
In 2008, the program was expanded to 16 community hospitals, and plans are underway for further expansion in 2009 to 6 additional tertiary care hospitals and 9 more community hospitals. After 2009, all 100 provincial hospitals with high numbers of pediatric cases will be targeted.
Performance measurement for pediatric HIVQUAL-T is conducted once a year; QI activities are planned annually following performance measurement reports. In August and September 2008, HIVQUAL-T workshops were held to share 2007 performance measurement results for Bangkok and Chiang Rai province. The pediatric workshops were attended by 154 different health care professionals including 34 doctors, 36 pharmacists, 46 nurses, 18 public health officers and 25 others. The multidisciplinary attendees shared QI topics, activities, and materials used in their QI work.
Since 2005, a number of successful QI projects have been implemented at participating pediatric sites, ranging from improving immunization coverage to assessing dental health for children living with HIV/AIDS. At Queen Sirikit National Institute of Child Health, the rate of HIV-infected children receiving an assessment of whether or not their immunizations are up to date rose from 8% to 100% between 2005 and 2006. Improvements implemented ranged from adding an immunization variable to the medical record form to reminding patients to bring their vaccine book to all visits. Performance measurement results were also reviewed at weekly staff meetings to continually motivate staff. At Siriraj Hospital, the proportion of HIV-infected children with abnormal oral health receiving appropriate treatment rose from 41% to 100% between 2005 and 2006, thanks also to a wide variety of QI activities: educational materials on oral health were developed for the clinic, a visiting dentist was brought in to conduct dental education classes, and fluoride was given to patients. Also, a “teeth beauty contest” was held in the HIV clinic for the children twice a year. Finally, review of performance measurement results was integrated into routine staff meetings.
The scale-up of pediatric HIVQUAL-T represents integration of the approach into the Thai national health system, and successful coordination between the Thailand National Health Security Office (NHSO), the MOPH and the Institute of Hospital Quality Improvement and Accreditation (IHQIA). Integration with adult HIVQUAL-T as a national program is currently being discussed, particularly in the context of the upcoming expansion to all provincial hospitals with high pediatric caseloads. As pediatric HIVQUAL-T continues to grow, cross-organizational collaboration will be essential. As the
main payor for healthcare in Thailand, the NHSO provides the budget, policy support and oversight for ensuring quality in HIV care. The MOPH provides technical leadership, training, monitoring and supervision for the pro--gram, whereas IHQIA provides technical assistance for QI training networks in Thailand. Also, TUC, the collaboration between the US Centers for Disease Control and Prevention (GAP Thailand) and the Ministry of Public Health provides technical support to the MOPH to strengthen the quality of HIV programs. As part of the HIVQUAL-T model, provincial health offices also sponsor regional QI meetings where providers discuss their experiences with one another.
HIVQUAL-T-PEDS is led by the MOPH with support from GAP-Thailand. The team from the MOPH includes Dr. Sanchai Chasombat and Chuenkamol Setthabut, with assistance from Dr. Peeramon Ningsanond. At GAP, the team includes Dr. Rangsima Lolekha, Worawan Faikratok and Suchin Chunwimaleung. Consultants to the pediatric program are Drs. Michelle McConnell, Kimberley Fox and Philip Mock of GAP. Also essential to the program are the many pediatricians and nurses at the participating pediatric hospitals.
INT NEWS HEADLINES
HQI Update - August 2010 - Improving TB Care and Treatment through Quality ImprovementClick here for full story
HQI Update - May 2010 - Retention
Click here for full story
HQI Update - April 2010 - ACLN
Click here for full story
HQI Update - March 2010 Now Available
Click here for full story
HIVQUAL at 2010 Int'l Forum on Quality and Safety in Health Care
Click here for full story
HIVQUAL International is supported through HRSA as the International Quality Center
for PEPFAR and through funding from UNICEF.
HIVQUAL International partners with the National Quality Center.
Terms of Usage
