Improving Quality of TB Data at Nine TB Diagnostic Treatment Units: Tested Changes and Guidance from Uganda
In Uganda, ASSIST worked with the MOH and implementing partners to build the capacity of health workers to be able to screen, diagnose, and manage TB to improve TB care services using the continuous quality improvement (QI) model as well as the collaborative approach. This change package details the experience of improving TB treatment response and provides guidance to others who may want to improve TB data quality.
In October 2015, a baseline assessment was conducted at the participating facilities during which records review and interviews with TB care providers were done to access different aspects of TB services. From the assessment, it was found that completeness and accuracy of TB data was very low (1.5%) at the participating health facilities. ASSIST built capacity of facility personnel to form QI teams and plan and implement improvement efforts.
By August 2016, data completeness and accuracy has increased to 87%. QI teams noted a number of improvements related to improved data quality. They increased the numbers of TB clients reviewed in the month. Before the intervention, clients were reviewed without documenting them in the TB tools like the TB unit register. This made it difficult to even account for TB medications dispensed. Improved data made for easy follow-up of TB clients who never kept their appointment, presumed clients who never reached the lab, and co-infected clients who were not initiated on septrin and ART.
These changes are recommended because the health facilities that tested them achieved reasonable improvement in the quality of TB data in the TB care tools. We therefore recommend that persons involved in TB work need to focus on:
• Periodic reviewing and utilizing of TB data
• Building capacity on TB monitoring tools
• Assigning roles
• Using reminders
• Coordinating between TB service centers
• Internal communication among health workers
This change package is intended to provide guidance among individuals and QI teams wishing to improve screening for TB. It provides the general idea and acts as a guidance on concepts with examples of innovative changes to improve screening for TB. Teams are urged to adapt these changes to suit their clinic settings for improvement to occur.