TECHNICAL ASSISTANCE OF CARE & TREATMENT PROGRAME

USAID/SMART TA
Technical Assistance
Period
Date of assessment

August,19/2014

Site information

OPC Ch Mi

Oct, 01, 2013

To

July, 30, 2014

SERVICE PROVIDED

ARV on Adult
ARV on Pediatrics

HIV testing

MMT

PMTCT

Home base care

Out-reach

TB

SERVICE PROVIDED

City

Rural

Mountainous

Patients in Prison
Others

Ethnics people

% Percentages estimated)

( % Percentages estimated)

Total patients under management: 317 ( 44pre-ARV/273 ARV)

Human resource

Name

Position

Dr. Phm Phc Hi

Part time:04
Phm
Full time: 04

Total: 08

Ph
a g H g

Hu h h Hu h S g
Phm h
h g
h
h g
Huynh Thanh Vu

Name of USAID/SMART TA site

monitor
Nguyn Nht Quang FHI 360

Contracted

Gov

Chief of OPC

Doctor
Doctor
Nurse/Data
management
Pharmacist
Counsellor
Support group
Support group

x
x

Name of OPC chief

1. Dr. Phm Phc Hi
2. Ms. Hunh Th Hunh
S g

x
x
x
x
x

Name of PAC representative

1. Ms.L Th Thanh Vn

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TECHNICAL ASSISTANCE OF CARE & TREATMENT PROGRAME

USAID/SMART TA
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

Result of HIVQual and SMART TA C&T Monitoring

indicators.
Round: from 1 /10/ 2013 to 31 / 3 / 2014

100%
95%
93%
100%
100%
67%
70%

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No

1
2
3
4
5
6
7
8
9
10
11
12

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 who visit the
OPC regularly (according the national guideline
every 3 months and per appointment with
Proportion of patients who were newly
registered at OPC was prescribed INH
Proportion of ARV patients visiting the OPC for
medication pick-up according to scheduled
appointment in the last visit
Proportion of ARV patients who are assessed
for medication adherence in the last visit
Proportion of patients were initiated ART within
15 days after eligible ART in last 6 months
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)

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

Achieve
SMARTTA
standard

80%

80%

50%

-30%

No

75%

44%

86.96%

43%

Yes

75%

80%

89.47%

9%

Yes

5.26%

5%

No

80%
85%

96.08%

96.26%

0%

Yes

95%

100%

99.07%

-1%

No

75%

93.75%

29.17%

-65%

No

90%

89.19%

100%

11%

Yes

80%

95.65%

100%

4%

yes

85%

84.62%

92.03%

7%

Yes

85%

96.30%

60%

-36%

No

63.64%

64%

No

80%

SMART monitoring TA Score

SMART TA site Classification

Improving

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

File nh gi d n
USAID/ SMART TA

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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
A
1
B

Situations
HUMAN RESOURCE 100%
No current issues. Need to
increase from GOV

Solution

Continue to discuss integration of OPC

into infectious disease department

Who in
charge
Dr.H , Cho
Moi OPC

Who support

Other
resources

PAC AG

FHI 360

Date to
complete

Date actual
completion

Notes

STRUCTURE AND ACCESS

TB Infection Control: Medical
mask available but not welldelivered to needed patients
(TB suspected/ coughing
patients)

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.

he e s t notice board
about working days, hours
of OPC

Ms.S g/
Ms.Tin

H h
Moi OPC

25/8/2014

Move the bulletin board about

working days, hours of OPC from
old place of OPC to current place of
OPC.

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TECHNICAL ASSISTANCE OF CARE & TREATMENT PROGRAME

USAID/SMART TA
C

DRUG SUPPLY
INH supply is not stable in past
time.

1
F

To maintain the supporting from Cho

Moi Hospital.

H h
Moi OPC

H h
Moi OPC

PAC AG

30/8/2014

Cho Moi
Hospital

PAC AG/
FHI 360

DATA MANAGEMENT 100%

No current issues

Will implement e-log book

CASE MANAGEMENT
Patient Follow-up: Follow-up
f efe al ases pat e ts late
re-examination, and poor
treatment adherence must be
improved.

Pharmacist.
g

LABORATORY CAPACITY 100%

No current issues

QI PDSA Activity #2
Plan sufficient INH to provide IPT for
new registered patients and those
continuing IPT.
Do:
OPC estimates an IHN planning sent
it to PAC AG monthly (end of month)
based on number of expected
number new patients and those
continuing IPT.
See:
Number of new registered patients
and those continuing IPT gets IPT.
Act:
Nurse and pharmacist report and
make an INH plan for next month.

QI PDSA Activity #3
Plan: Increase the rate of alive and
retention in care of the all the patients
including Pre-ART and ART
Do:
Triage nurse make a book records for
lost follows up, death, late reexamination, referral cases, and make
a plan for contacting to patients and
their families: phone to them to
remind for re-examination, confirm
the successful referral.
Counselor provide counseling session
to the patients on benefits of early

Ms S g/
Ms.Tin

H h
Moi OPC

Start from
30/8/2014

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USAID/SMART TA
treatment, significance of treatment
adherence, etc.;
Coordinate with the commune health
station / community support groups
to find cases lost to follow / untreated.
Implementation of LTFU SOP
See:
Number of patients who show late reexamination and poor treatment
adherence and see the records at the
record books.
Number of cases contacted
successful.
Act:
Continue with the action above
G

ART/PRE-ART DELIVERY ART

HIVQUAL Indicator
Indicator 03 achieved 5,26%
NH insufficient
OPC staff has not been
clearly guidance on IPT.

QI PDSA Activity #4
Plan: Increase the proportion of
patients who were newly registered at
OPC was prescribed INH to 80%
Do:
Estimates amount of INH for IPT
Update / attend training courses on
INH prophylaxis for OPC staff.
Enhanced benefits counseling on INH
prophylaxis for patients.
Doctor indicates IPT for Pre-ART and
ARV patients according to the IPT
guideline of VAAC.
See:
Number of newly registered at OPC
will be prescribed IPT
Act: Continue with the action above

H h
Moi OPC
Ms S g/
Ms.Tin

PAC AG/
FHI 360

PAC AG/
FHI 360

Start on
30/8/2014

s g

PAC AG

FHI 360

Start on
30/8/2014

Ms S g/
Ms.Tin

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TECHNICAL ASSISTANCE OF CARE & TREATMENT PROGRAME

USAID/SMART TA
Indicator 06: from 29.17% to
75%
Patients usually returned to
receive CD4 results late:
Patients d d t want to ART
for fear of disclosure of HIV
status.
Patients still felt strong so
they were subjective.
Patients work away, so
d d t want treatment.

QI PDSA Activity #5
Plan: Proportion of patients were
initiated ART within 15 days after
eligible ART in last 6 months will be
achieve >75%
Do:

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 record.
Nurse call the new eligible patients
for remind them back OPC before
appointment day.
OPC Doctors review all newly
eligible patients d d t ba k t OP
for re-examination 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
Act: Continue with the action above

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TECHNICAL ASSISTANCE OF CARE & TREATMENT PROGRAME

USAID/SMART TA

SMART TA indicators
Survival rate after 12
months on ART: 60% to
85%
Retention rate after 12
months on the program:
63.64% to 80%

Plan: Increase the rate of alive and

retention in care of the all the patients
including Pre-ART and ART
Do : as activity # 3
See: as activity # 3
Act : as activity # 3

Peers
Ms S g/
Ms.Tin

H h
Moi OPC ,
And
commune
health station

PAC AG/
FHI 360

Start on
30/8/2014

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