Strengthening the HIV Response in the Dominican Republic to Reach “Treatment for All” through Quality Improvement Collaboratives

Dr. Herman Willems, JSI HIV Clinical and Quality Improvement Advisor, facilitating the workshop.

QI collaborative team from the Dr. Francisco A. Gonzalvo Hospital, La Romana participating in the ice breaker activity.

The team from the Instituto de Estudios Virológicos, Santo Domingo at work.

JSI Research & Training Institute’s Advancing Partners & Communities (APC) project organized a Quality Improvement (QI) Collaboratives Launch Workshop in Santo Domingo, Dominican Republic (DR) from January 31 to February 2, 2018. The workshop was attended by 90 participants, including representatives from the Ministry of Public Health and the National Health Service (NHS), site level HIV clinic staff from 11 PEPFAR-supported sites, and technical and program staff from CDC, USAID and other PEPFAR funded implementing partners.

APC is the key USAID implementing partner for the PEPFAR funded Treatment for All strategy in the DR. The strategy is focused on reaching key and priority populations at highest risk of HIV/AIDS in the DR and supports the government’s efforts to control the epidemic through implementation of the 90-90-90 treatment target established by the Joint United Nations Programme on HIV/AIDS.

In this second year of implementation of the Treatment for All strategy, APC is leading USAID’s initiative to create QI collaboratives at 11 PEPFAR-supported sites, in collaboration with the NHS, the key government partner responsible for HIV care and treatment services, and other PEPFAR partners. The purpose of the QI collaboratives is to enhance performance of the PEPFAR-supported sites to meet the site-level targets for HIV testing, linkage to care and treatment, retention in care and suppression of viral load, and to improve the quality of care that will help to reduce the number of new HIV infections, morbidity of people living with HIV and HIV related deaths.

The workshop was designed and facilitated by JSI staff including, Dr. Herman Willems, HIV Clinical and Quality Improvement Advisor; Alexia Eslan, QI Collaboratives Senior Consultant; Marilyn Noguera, APC Country Program Manager; and Angela de León, APC Director of Programs and QI in the DR. The workshop sessions focused on the application of standardized QI processes and tools to quantify gaps in HIV care and treatment at each site; identify the root causes of barriers to reaching established targets; and prioritize the interventions to be tested, measured and adapted.

The QI launch workshop led to the establishment of a QI collaborative at each of the 11 PEPFAR supported HIV clinics. This includes 20 quality improvement teams that are now being coached by APC program coordinators and other PEPFAR implementing partners.

It is expected that implementation of the QI collaboratives in the DR will result in a systematic and sustainable QI process that supports the PEPFAR targets and quality standards that will be transferrable to HIV clinics in additional provinces.