Application of the Deming PDSA Cycle as a Patient Experience Management Tool to Improve HIV Care. An Action Research in Under-Resourced Settings of Jinja-Uganda

Abstract

The study to determine the effect of patient experience management using the Deming PDSA cycle on the quality of HIV care was conducted in under-resourced settings of Uganda. The interventional study had 437 files studied, and 224 adult HIV clients with poor HIV care outcomes of; missed appointments for more than two weeks, poor adherence to treatment of < 85%, and unsuppressed viral load of > 1000 viral copies per milliliter were interviewed at baseline and end line. The study revealed a 13.6% prevalence of the study HIV care outcomes among all the client files, the majority of which were for patients in care for more than four years. 11.8%, 65.2%, and 46.5% were due to poor adherence to treatment, two weeks missed appointments, and unsuppressed viral load at baseline, which reduced to 4.7%, 25.1%, and 31.5% at end-line assessment, respectively. 80% of the studied clients were retention in care between the baseline and end-line assessments. 7.7% of the study files had never had a viral load done to the clients at baseline, which reduced to 1.4% at the end line. 34.5% of the study client files were overdue for a viral load at baseline but only 16.8% at end-line assessment. The study also showed a general improvement on the patient experience before and after interventions. In conclusion, Patient Experience Management using the Deming PDSA cycles improves the quality of HIV care in under-resourced settings.