Publication: Pediatric HIVQUAL-T: Measuring and improving the quality of pediatric HIV care in Thailand, 2005-2007
Issued Date
2010-01-01
Resource Type
ISSN
15537250
Other identifier(s)
2-s2.0-78651263351
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Joint Commission Journal on Quality and Patient Safety. Vol.36, No.12 (2010), 541-551
Suggested Citation
Rangsima Lolekha, Suchin Chunwimaleung, Rawiwan Hansudewechakul, Pimsiri Leawsrisook, Wasana Prasitsuebsai, Pramot Srisamang, Jurai Wongsawat, Worawan Faikratok, Sarika Pattanasin, Bruce D. Agins, Kimberley K. Fox, Michelle S. McConnell Pediatric HIVQUAL-T: Measuring and improving the quality of pediatric HIV care in Thailand, 2005-2007. Joint Commission Journal on Quality and Patient Safety. Vol.36, No.12 (2010), 541-551. Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/29910
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Title
Pediatric HIVQUAL-T: Measuring and improving the quality of pediatric HIV care in Thailand, 2005-2007
Other Contributor(s)
Thailand Ministry of Public Health
TUC
Pediatric Antiretroviral Treatment (ART) Clinic
Chiangrai Prachanukroh Hospital
Queen Sirikit National Institute of Child Health
Mahidol University
The HIV Netherlands Australia Thailand Research Collaboration
Sapprasittiprasong Hospital
Bamrasnaradura Infectious Disease Institute
New York State Department of Health
Centers for Disease Control and Prevention
Organisation Mondiale de la Sante
CDC
Ho Chi Minh City Oncology Hospital
TUC
Pediatric Antiretroviral Treatment (ART) Clinic
Chiangrai Prachanukroh Hospital
Queen Sirikit National Institute of Child Health
Mahidol University
The HIV Netherlands Australia Thailand Research Collaboration
Sapprasittiprasong Hospital
Bamrasnaradura Infectious Disease Institute
New York State Department of Health
Centers for Disease Control and Prevention
Organisation Mondiale de la Sante
CDC
Ho Chi Minh City Oncology Hospital
Abstract
Background: As increasing numbers of children initiate antiretroviral treatment (ART), a systematic process is needed to measure and improve pediatric HIV care quality. Methods: Pediatric HIVQUAL-T, a model for performance measurement and quality Improvement (QI), was adapted from the U.S. HIVQUAL model by incorporating Thai national guidelines as standards. In each of five pilotsite hospitals in Thailand in 2005-2007, clinical data abstracted from parient records were used to identify priority areas for QI. Improvement strategies were designed by clinic teams in different care system areas, and indicators were remeasured in 2006 and 2007. Results: At the five hospitals, 1,119 HIV-infected children younger than 15 years of age received care in 2005, 1,183 in 2006, and 1,341 in 2007-of whom 460, 435, and 418, respectively, were selected for chart abstraction. Of the eligible children, ≥ 95% received clinical monitoring, annual CD4 count monitoring, ART, and adherence and growth assessments; 60%-90% received Pneumocystis jiroveci pneumonia (PCP) prophylaxis, tuberculosis (TB) screening, oral health assessments, and HIV disclosure. Indicators with a score ≤ 40% in 2005 but with significant improvement (p <.05) in 2006-2007 following QI activities were Mycobacterium avium complex (MAC) prophylaxis, and cytomegalovirus (CMV) retinitis and immunization screenings. Conclusions: Despite the promulgation of national guidelines, performance rates of some pediatric HIV indicators needed improvement. The pediatric HIVQUAL-T model facilitates use of hospital data for pediatric HIV care improvement and indicates that the U.S. HIVQUAL model is adaptable to developing countries. Copyright 2010 © The Joint Commission.