TECHNICAL ASSISTANCE OF CARE & TREATMENT PROGRAME

USAID/SMART TA
Technical Assistance
Period
Date of assessment

Oct, 01, 2013

To

June, 30, 2014

Tht Nt-Cn Th

Site information
DCH V CUNG CP

ARV on Adult
ARV on Pediatrics

HIV testing

MMT

PMTCT

Home base care

Out-reach

TB

SERVICE PROVIDED

City

Rural

Patients in Prison
Others

% Percentages estimated)

( % Percentages estimated)
Total patients under management: 408 ( 23 pre-ARV/385 ARV)
Name
Phm Tr Hng
Nguyn Th Minh Giang
Cao B Trung
Nguyn Th Thu Trang
Hunh Th Kim Chu
inh Vn Ph

Full time: 10

Mountainous

Ethnics people

Human resource
Part-Time:03

Cao Th Xun
Dng Minh Tun
Phm Th Kim Dung
L Th Yn
Nguyn ng Khoa
Hunh Vn Bo

Total: 13
Phm Th M

Name of USAID/SMART TA site

monitor
Nguyn Nht Quang, FHI360

Position
Chief of OPC
Medical doctor
Medical doctor
data
management
Administrative
laboratory
technician
Pharmacist
Pharmacist
Counsellor
Counsellor
Counsellor
Support group
member
Peer group
member

Name of OPC chief

1.
2.
3.
4.

Dr.Trn Tr Hng
Mrs.Nguyn Th Thu Trang
Mrs.Dung
Mr.Ph

Contracted

Gov
X
X
X

X
X
X
X
X
X
X
X
X
x

Name of PAC representative

1. Dr.Nguyn Th Bch Qu

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TECHNICAL ASSISTANCE OF CARE & TREATMENT PROGRAME

USAID/SMART TA
Result of HIVQual and SMART TA C&T Monitoring indicators.
Round: from 1 /10/ 2013 to 31 / 3 / 2014
Assessment items
A
B
C
D
E
F
G

HUMAN
RESOURCES
STRUCTURE AND
ACCESS
DRUG SUPPLY
LABORATORY
CAPACITY
DATA
MANAGEMENT
CASE
MANAGEMENT
ART/PRE-ART
DELIVERY ART

Rate of
achievement
96%
95%
100%
90%
90%
100%
56%

HIVQUAL and SMART TA INDICATORS

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TECHNICAL ASSISTANCE OF CARE & TREATMENT PROGRAME

USAID/SMART TA

No

1
2

Name of indicators

The rate of medical records achieved over 80%

assess by SMART TA Tool
Proportion of patients who newly registered at
the OPC in last 6 months are tested for CD4
within 15 days of enrolment
Proportion of pre-ARV patients visiting the OPC
for medication pick-up according to scheduled
appointment in the last visit

Results at
the time
SMART TA Previuos
The
of
standard
result
difference
evaluatio
n

Achiev
SMARTT
standar

80%

100%

100%

0%

Yes

75%

76.60%

75.00%

-2%

Yes

75%

64%

95.00%

31%

Yes

17.65%

18%

No

Proportion of patients who were newly

registered at OPC was prescribed INH

80%

Proportion of ARV patients visiting the OPC for

medication pick-up according to scheduled
appointment in the last visit

85%

92.17%

76.47%

-16%

No

Proportion of ARV patients who are assessed

for medication adherence in the last visit

95%

100.00%

98.20%

-2%

Yes

Proportion of patients were initiated ART within

15 days after eligible ART in last 6 months

75%

100%

86.96%

-13%

Yes

90%

97%

74.14%

-23%

No

80%

97%

100.00%

3%

Yes

85%

84%

94.02%

10%

Yes

85%

83.18%

82.86%

0%

No

80%

0%

77.55%

78%

No

8
9
10
11
12

File nh gi d n
USAID/ SMART TA

Proportion of qualified HIV patients are

prescribed for Cotrimoxazole or DAPSONE for
the last visit
Proportion of patients are screened for TB in
the last medical visit
Proportion of patients are tested CD 4 at least 1
in last 6 months
Proportion of patients who still alive and on
treatment after 12 months on ART (NGI ID)
Proportion of patients retained in care after 12
months of registration (SMART TA
recommended ID)

SMART monitoring TA Score

SMART TA site Classification

Improving

File of data assessment (see the attachment Excel file below)

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TECHNICAL ASSISTANCE OF CARE & TREATMENT PROGRAME

USAID/SMART TA

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TECHNICAL ASSISTANCE OF CARE & TREATMENT PROGRAME

USAID/SMART TA

No

Situations

HUMAN RESOURCE :
There is a new doctors at the OPC
have not experience on HIV/AIDS
treatment.
STRUCTURE AND ACCESS :
TB Infection Control: Medical
mask available but not welldelivered to needed patients (TB
suspected/ coughing patients)

1
B

C
1
D

Solution

Practicum training by doing on

actual daily working.

QI PDSA Activity #1
Plan: Implement active TB
infection control and prevention
Do:
- Triage nurse distributes medical
mask for needed patient (TB
suspected/coughing patients)
- Counselor provides counseling
session for the TB
suspected/coughing patients to
understand the importance of
medical mask wearing.
See:
After 1 month, the OPC counts
how many medical masks
have been distributed and if
they are provided
appropriately for the TB
suspected/coughing patients.
Act:
Triage nurse leads discussion
of data and team provides
feedback, solutions, and plan
for ongoing monitoring.

Who in charge

Dr.

ng

Ms. Dung/Ms.Yn

Who
support

Other
resources

Date to
complete

CT PAC

PMC Th

12/2014

Dr.Hng

Date
actual
completion

Notes

30/8/2014

DRUG SUPPLY : 100%

No current issues

Continue maintaining

LABORATORY CAPACITY : 100%

Continue maintaining

No current issues

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TECHNICAL ASSISTANCE OF CARE & TREATMENT PROGRAME

USAID/SMART TA
E

DATA MANAGEMENT : 90%

There was different data between
Log Book and software on
Computer (as Death /Loss
/Transferal cases.) because OPC
didn updated data in weekly /
monthly.
CASE MANAGEMENT : 100%
Improve Successful referral rate of
OPC- OPC referral.

Mrs. Trang

OPC to appoint one staff to

keep track of referral and
have logbook to record
transfers, contact and confirm
with other OPC before and
after refer Patients.

Ms.Dung/Ms.Trang

QI PDSA Activity #2
Plan: pre-ARV patients who visit
the OPC
Do:
Counselors need to provide
technical advice on the
benefits of the package of
care and treatment for preART patients.
Doctors should discuss with
patients schedule for
appointments to suit with
patients.
Reception staff and C&T
support team make a book
monitor immediately for PreART patients, call to remind
patients before reexamination.

Dr. Hng/Support
group

30/8/2014

Mr. Bo

30/8/2014

ART/PRE-ART DELIVERY ART 56%

HIVQUAL Indicator
Indicator 2:
Proportion of pre-ARV patients
visiting the OPC for medication
pick-up according to scheduled
appointment in the last visit, from
95 to 98%

Begin to update C&T data into

Software on computer
weekly/monthly in August 2014.

Dr.Qu , CT
PAC

12/2014

See: Number of pre-ARV

patients who return OPC for
regularly re-examination on time
Act: Continue with the action
above

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TECHNICAL ASSISTANCE OF CARE & TREATMENT PROGRAME

USAID/SMART TA

Indicator 6:
Proportion of patients were
initiated ART within 15 days after
eligible ART in last 6 months from
86.96% up to 90%

QI PDSA Activity #3
Plan: Proportion of patients were
initiated ART within 15 days after
eligible ART in last 6 months.
Do:

The patients usually returned to

receive CD4 results late:
Patients didn want to
ART for fear of disclosure
of HIV status
Patients still felt strong so
they were subjective
Patients work away, so
didn want treatment

Counselor: Enhancing
counseling for patients on
benefits of early
antiretroviral therapy so
encourage them returned
to get CD4 result follows the
appointment schedule
when take blood of the
patients for CD4 count
testing.
Triage nurse to check who
will have CD4 test and
sticking a yellow sticker on
the medical records.
Nurse call the new eligible
patients for remind them
back OPC before
appointment day.
OPC Doctors review all
newly eligible patients who
didn back o OPC for reexamination and inform to
Nurse.
Nurse/support team
continue to call the eligible
patients to encourage them
back OPC to receive CD4
results and should start ART
early.

See:
Number of receiving ARV in
15 days after ART eligible

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TECHNICAL ASSISTANCE OF CARE & TREATMENT PROGRAME

USAID/SMART TA
Act: Continue with the action
above

SMART TA indicators
Survival rate after 12 months
on ART from 82.86 % to 85%
2

Plan: Increase the rate of alive

and retention in care of the all
the patients including Pre-ART
and ART
As QI PDSA Activity #2,#3

Dr. Hng/Support
group

Dr.Qu , CT
PAC

12/2014

Retention rate after 12

months from 77.55% to 80%

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