DATA FOR ACTION: SUPPORTING QUALITY

PROGRAMS

Andrea A. Howard, MD, MSDirector, Clinical & Training Unit

Associate Professor of Clinical Epidemiology

WHERE ICAP WORKS

MOROCCO

ALGERIA

MAURITANIA

MALINIGER

LIBYA

CHAD

EGYPT

SUDAN

ETHIOPIA

KENYA

TANZANIA

DEMOCRATIC

CENTRAL

RWANDA

GABON CONGO

NIGERIABENIN

DTVOIRE

SENEGAL

GHANA

CAMEROON

ZAMBIA

MOZAMBIQUEZIMBABWE

BOTSWANA

SWAZILAND

LESOTHO

NAMIBIA

ANGOLA

OF THE CONGO

REPUBLIC

REP. OF

COTE

BURKINAGUINEA

SOUTH

REPUBLIC

AFRICAN

THE

AFRICA

Uzbekistan

Turkmenistan

Uzbekistan

Kyrgyzstan

Tajikistan

Kazakhstan

MALAWI

Track 1.0 Program

Dec-04

Mar-05

Jun-05

Sep-05

Dec-05

Mar-06

Jun-06

Sep-06

Dec-06

Mar-07

Jun-07

Sep-07

Dec-07

Mar-08

Jun-08

Sep-08

Dec-08

Mar-09

Jun-09

Sep-09

Dec-09

Mar-10

Jun-10

Sep-10

Dec-10

Mar-11

Jun-11

Sep-11

Dec-11

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

0

100

HIV Care ART

CUMULATIVE ENROLLMENT IN HIV CARE AND TREATMENT

Source: ICAP URS February 2012.Notes: Data are only from clinics supported and reporting.

Num

ber o

f pat

ient

s Number of clinics

499,194 on ART

1,018,204 in care

757clinics

USE OF DATA FOR QUALITY:

ICAP APPROACHES• Web-based reporting and data

management• Small scale manual measurement of

ICAP Standards of Care • Standardized performance

measurement of ICAP Priority Indicators using aggregate data

4

WEB-BASED REPORTING AND DATA MANAGEMENT

• Unified Reporting System (URS): central facility-centered, aggregate-based system to capture and disseminate real-time relevant program data on multiple ICAP-supported activities and programs

• Aims to streamline, standardize, and increase the efficiency and utilization of routinely collected data by any ICAP staff member at all levels of the organization

URS CORE COMPONENTS• Site census enumerates supported facilities and

activities, and links data from multiple program areas at the facility level

• Capacity to accept data via manual entry or XML import

• Dashboards and user-defined reports provide data summaries by various geographic levels and program areas– Drill down capability for multi-country, country, district,

facility-level data• Integrated Google Maps for real-time map display

of ICAP- supported facilities• Export of reports or raw data into Excel or

statistical software

DASHBOARD BY COUNTRYProgram area module

Country

FILTER BY DISTRICT

FILTER BY SITE

AUTOMATED FEEDBACK REPORTS-COUNTRY

AUTOMATED FEEDBACK REPORTS - COUNTRY

AUTOMATED FEEDBACK REPORTS - SITE

AUTOMATED FEEDBACK REPORTS - SITE

STANDARDS OF CARE

SOC DATA COLLECTION TOOLFacility name: _____________________________________ Collected by: _________________________________ Date evaluated: _____/_____/________

Period evaluated: _____/_____/_______ to _____/_____/________

2. Investigations 3. TB Dx 4. CPT 2. InvestigationsSOC 1a SOC 2a SOC 3 SOC 1b SOC 2b SOC 8

Pt screened for TB at enrolment (any

symptoms or "NO SYMPTOMS" ticked)

Patient screened

positive for any TB symptom

Patient who screened positive for TB symptoms

had appropriate investigations done for PTB

or EPTB

Patient diagnosed with any type of

active TB

Patient diagnosed with TB and on

CPT

Pt screened for TB at last visit in HIV care or on ART

(any symptoms or "NO SYMPTOMS" ticked)

Patient screened positive for any TB

symptom

Patient who screened positive for TB symptoms

had appropriate investigations ordered for

PTB or EPTB

Pt screened negative for TB symptoms without contra-

indications for INH

Patient started on IPT

N/A (not screened)

N/A (not screened or screened neg)

N/A (not screened/ screened neg/no

invest.)

N/A (not screened/ screened neg/no

invest./no TB)

N/A (no visit since enrolment or on TB treatment before

the last visit)N/A (no visit or on

TBRx or not screened)N/A (no visit or on TBRx or not

screened or screened neg) N/A (not screened)

N/A (not screened or screened pos or contra-

indications)

0=NO 0=NO 0=NO 0=NO 0=NO 0=NO 0=NO 0=NO 0=NO (screened pos or contra-ind)

0=NO

1=YES 1=YES 1=YES 1=YES 1=YES 1=YES 1=YES 1=YES 1=YES 1=YES Notes / Comments123456789

1011121314151617181920

TotalCode a. b. c. d. e. f. g. h. k. l.

Calcula-tion

a/# charts reviewed (b/a) c/b (d/c) e/d f/(# charts reviewed - pts on TBRx at last visit) (g/f) h/g l/k (all x 100%)

% Version 5, Nov 2010

SOC TB/HIV: TB screening for HIV-infected patients; IPT for patients in HIV care

At the last visit in HIV care or on ART Isoniazid Preventive TherapyIPT

NB: EXCLUDE CHARTS OF PATIENTS ALREADY ON TB TREATMENT AT THE TIME OF ENROLMENT!

Patient file no

1. TB screening at enrolmentAt enrolment into HIV care

1. TB screening at the last visit

JOB AID TO EVALUATE SOC

FACILITY FEEDBACK FORM

PRIORITY INDICATORS• Performance measurement using aggregate data• Very minimum set of indicators• Across domains• Standardized across organization• Linked to targets• Trends over time