Table 1 QI projects implemented by Son La HIV clinics

Lab testing (ALT, hemoglobin and CD4) (6 clinics)

- Place template for monitoring routine testing in all patient charts

- Review which patients will need lab testing prior to clinic

- Schedule patients who will require similar testing on the same day

- Review reasons for routine testing with patients

- Contact patients who will need lab tests 1–2 days in advance

- Make specific date for doing CD4 test each quarter

- Review all patients who need to do CD4 test

TB screening (5 clinics)

- Use TB stamp or write 4 TB symptoms screening questions in chart

- Remind staff in weekly meetings.

- Place reminders on doctor’s desk to record TB screening

Missed visits (5 clinics)

- Logbook created and used to monitor missed visits

- Follow up missed visits with phone call or home visit (treatment supporters or nursing staff)

- Improve counseling on importance of attending scheduled clinic visits for patients starting and on ART

- Update patients’ contact information at each visit

- Group patients and schedule on the same day each month to more easily monitor for missed visits.

CTX prophylaxis (2 clinics)

- Review all eligible patients not yet on CTX

- Update clinic staff on new guideline on CTX prophylaxis

- Make plan for preparing CTX in advance

- Document in patient charts if patient buys CTX at outside pharmacy

ART initiation within 30 days (2 clinics)

- Make a list of eligible patients to contact and remind them to come to clinic for ART treatment

- Improve counseling prior to ART eligibility for patient at each visit

Patient chart documentation (4 clinics)

- Review required elements of chart documentation at staff meetings

- Improve organization and filing of charts, and ensure all charts have complete patient identification number.

- Review and complete demographics, treatment summary and test monitoring pages for all patient charts

- Review patient charts at the end of each clinic day to finalize information