From the HIVQUAL International Update

 HIVQUAL-Nigeria QI Spotlight: University College Hospital, Ibadan

The University College Hospital is affiliated with the University of Ibadan, one of Nigeria’s premier and oldest institutions of higher learning.  Located in Oyo State, approximately 100 kilometers north of Lagos, Ibadan is home to more than 2.5 million people.  In addition to its affiliation with the University, UCH receives support for its HIV/AIDS program from Harvard University’s APIN+ program, a PEPFAR implementing partner.

As one of the initial 20 pilot sites for the HIVQUAL-Nigeria, UCH has benefited considerably from participating in the program.  In particular, waiting times for patients have been reduced thanks to improvements in provider schedules and appointment procedures.  Patients have also become more involved in quality-related activities, and staff have become routinely engaged in continuous quality improvement.

After reviewing data from the first round of data collection, UCH identified several key areas for improvement, including CD4 monitoring and continuity of care for patients not receiving ART.  To improve performance on both of these indicators, a multi-pronged approach was developed by the staff.  To encourage patient attendance for appointments, waiting times at the facility have been reduced and counselors routinely remind patients by telephone of upcoming appointments.  For CD4 monitoring in particular, staff use the laboratory database to track patients due for upcoming labs.

The interventions have been successful largely due to the commitment and buy-in of the staff, gained by the multidisciplinary quality  improvement project team that includes patients, counselors, support group staff and data officers, in addition to clinical and laboratory providers.  Significant improvements have been observed: the number of patients (both ART and non-ART) attending appointments every six months has increased, as has the number of CD4 laboratory tests performed at the hospital.  In particular, CD4 monitoring for non-ART patients  has improved from 71% to 80%  in just a few months.