How timely downloading and filing of patient viral load result can lead to reduction in turnaround time and improve service delivery.

Members:    • Erick Jumba - Content expert
                     • Violet Kisato - Content expert
                     • Beat Malala -Content expert
                     • Gladys Ekesa - Data manager
                     • Eunice Nganda - Member
                     • David Kinyanjui - Member
                     • Wanda Jones Ago- Lead
                     • Awuor Ochieng- Secretary
                     • Omuli Agufa- Frontline Team
                     • Lauryn Amiga – QI Expert
                     • Hilda Shamala- Member

INTRODUCTION

The project was about ensuring that hard copies of the viral load results were availed in the patients files at Kakamega County General Teaching and Referral Hospital CCC department. As a result of these efforts, monitoring of clients’ viral load suppression was achievable. This was important because we were concerned about timely clinician interpretation of results and clients’ overall health.

AIM

The project sort to increase the percentage of hard copy viral load results in the patient files from 42% In September 2018 to 90% by March 2019.

METHOD

Baseline data was derived from 150 files abstracted from June, July and August 2018 which showed that only 42% of files had the viral load hard copy results.
The metric selected was:-
                                                    Numerator: Number of hard copy VL results in the files.
                                                    Denominator: Number of Viral Load results received.

Baseline Data:
42% of files had VL hard copy results
The data was initially collected monthly and analyzed but the frequency was increased to twice per week to cover for the lost collection points in order to achieve a minimum of 25 collection points in the project. The data collected was then fed into the spreadsheet which was then commanded to develop graphical presentations. The projections were presented to the LARC team KCGTRH biweekly for interpretations and adjustments to course.

RESULTS

Small Test of Change 1 (PDSA) - November
                                       • Data was analyzed biweekly and presented monthly.
                                       • VLs hard copy results hard risen from baseline of 42% to 75% by end of November.
Small Test of Change 2 (PDSA) - March
                                       • Data analyzed 2 times weekly.
                                       • Viral load hard copy results in files had risen from baseline of 42% to 81% by end of February.

CONCLUSION

• Through filling hard copies in the patient’s files we have reduced the number of patients who go home with wrong results.
• Minimal time is spent in spaghetti movement since we just check the VL results at the back of the file.
• With registers and job aids placed at the work stations, the time for new clients is quality and they are more confident with the services provided.
• The new VL SOPs allow for professional service provision.
• It has been easy for the Clinicians to quickly optimize clients, to start STF interventions and to promptly switch regimes without unnecessary delays.
• Simple job reassignments can greatly improve work output.