Continuous Quality Improvement Collaborative in the Caribbean

Since 2013, I-TECH has led quality improvement (QI) collaboratives in the Caribbean region, enabling multidisciplinary teams at health facilities to work toward a common goal of improving care and treatment for HIV-positive patients.

The current QI collaborative is focused on improving three primary drivers of virologic suppression: early identification and management of virologic failure; adherence to medication; and efficient, patient-centered, high-quality visits.

Facility-based QI teams meet as a collective for periodic learning sessions where they are taught QI methods, share their results, and learn strategies from other teams. Between learning sessions, teams receive coaching from local, regional and international experts, participate in webinars, implement Plan-Do-Study-Act cycles, and track related data. Data monitoring and utilization underpin all QI activities.

Recent QI work has focused on the following:

  • Patient Engagement: Regional and national QI collaboratives emphasize patient engagement as a way to drive quality improvement. I-TECH is encouraging and facilitating health care workers and patients to work together to identify solutions to the challenges they face. As the most widely embraced patient-engagement approach, QI teams involve patients and I-TECH works to support the expanded integration of patients on QI teams.
  • Differentiated Care: Site-based QI teams are testing patient-centered differentiated models of care that assist in overcoming obstacles to care and serve to improve retention in care and adherence to medication to increase viral load suppression.
  • Hardwiring Changes: I-TECH works with teams to review the data about changes, support teams through a process of iterative testing in a range of conditions, and ultimately to maintain data-validated improvements by building proven changes into standard, permanent practices within healthcare organizations.
  • Sustainability: I-TECH has collaborated with QI teams and local Ministries of Health to ensure that QI work is ongoing. I-TECH is currently in the process of developing a QI Framework and QI Toolkit to provide healthcare personnel at all levels with resources to maintain site- and regional-level QI initiatives.