Quality Improvement Collaborative Newsletter - A Before and After in the Dominican Republic
At the request of USAID, the PEPFAR-funded APC project in the Dominican Republic is supporting implementation of a Quality Improvement Collaborative (QIC) to improve access, quality and management of HIV care and treatment services for the key and priority populations with the highest HIV prevalence in the country – men who have sex with men, transgender people, female sex workers and the Haitian migrant population.
The QIC methodology and tools have been adapted to the Dominican context and are being implemented at PEPFAR-supported clinical sites under the leadership of the National Health Service (NHS) in collaboration with other PEPFAR implementing partners.
This issue of the Quality Improvement Collaborative (QIC) Newsletter tracks the timeline from the conceptualization, launch, and implementation of the QIC model at the PEPFAR-supported clinical sites. This model supports the Government of the Dominican Republic (GODR) expansion of the “Treatment for All” strategy to meet the country’s 90-90-90 treatment target established by the Joint United Nations Programme on HIV/AIDS (UNAIDS) to achieve control of the HIV epidemic by 2020.
Members of the quality improvement teams from the PEPFAR-supported clinical sites presented evidence of the success of the QIC model after only eight months of implementation from February to September 2018 at an event hosted by the National Health Service (NHS). Data and graphs showing the results of the Plan-Do-Study-Act (PDSA) cycles implemented at the sites and the impact on the HIV treatment cascade received applause from representatives of the government, donors and implementing partners who attended the event. Implementation of the QIC has contributed to progress in outreach and effectiveness of HIV testing, an increase in the number of people diagnosed with HIV who initiate antiretroviral therapy and a growing proportion of ART patients who have achieved viral suppression in the country. Lessons learned and best practices identified by the QI teams and shared through quarterly QIC Learning Sessions are being adopted at other clinical sites.
With the endorsement of the QIC model by the Director of the National Health Service, APC is expanding implementation of the QI methodology and tools to additional PEPFAR-supported sites in FY 2019 and developing a transition plan for rollout of the model to the remaining HIV clinical sites in the country.