Continuous quality improvement in AIDSRelief supported HIV treatment clinics in Uganda: An evaluation of “See-Try-Observe-Continue” (STOC) model in patient care

Abstract

Aim: To evaluate the effectiveness of the STOC model for continuous quality improvement in improving patient care in two AIDSRelief (AR) HIV treatment facilities in Uganda Methods: In the initial stages, health workers in 17 AIDS Relief HIV treatment facilities were trained in continuous quality improvement (CQI). Consequently, the health workers built CQI teams and used a See Try Observe Continue (STOC) model adapted from the Plan Do Study Act (PDSA) approach to improve gaps identified for change and evaluated their success. A simple excel tracking tool was developed to follow up on the progress of the use of paediatric pharmacy order forms in Bushenyi Medical Centre (BMC) as well as missed ARV pick up in Kabarole hospital. Both descriptive and graphical findings were recorded during the pre and post follow ups. Results: The different clinics implemented at least one cycle of STOC for specific problems and registered improvements in patient care. At BMC, there was an improvement of usage of the paediatric pharmacy order forms from 50% of the paediatric patients seen in each month as well as improved recording of children's weight and height, parameters crucial in growth monitoring. There was a significant reduction in number of patients who missed picking their ARVs from 28/1000 in Month 1 to 5/1000 in month 7 to 1/1000 patients in month 10. Conclusion: STOC model encourages and enhances evidence-based practices in the AR clinics. CQI activities enhanced by implementation of STOC to improve identified gaps at the facilities are imperative to achieving effective patient care.