TA PLAN FORM (v 4.8.14.

0)
USAID/SMART TA
ASSESSMENT PERIOD

1/10/2013

DATE OF ASSESSMENT

12/09/2014

To

30/6/2014

SITE INFORMATION
SERVICES PROVIDED

ARV for adults

ARV for children

HTC

MMT

PMTCT

C&S

Out-reach

TB

STI

AREA

City

Rural

Mountainous

OTHERS

Clients in prison

% total clients)

Ethnic group clients

% total clients)

Total clients under management:

HUMAN RESOURCES

Name

Position

Full-time: 13
Part-time: 1
Total: 14

Hien

OPC chief,
doctor
Doctor
Nurse,
secretary
Counselor

Khue
Hang
Nguyet
Hau
Hien
Nhung

Name of USAID/SMART
TA provincial site
monitor
Dr. Tran Tri Danh

Pharmacist
Peer, C&S
team

827 (105 Pre-ART/ 722 ART)

Contracted
Part-time
Full time

Gov
Part-time Full-time
x

X
x
X

X
x

Name of OPC chief

Name of PAC
representative

Dr. Tran Anh Hien

Pham Thi Mong Thuong

File assessment data

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TA PLAN FORM (v 4.8.14.0)

USAID/SMART TA

TA Assessment
Summary Results
A

HUMAN RESOURCES

STRUCTURE AND
ACCESS

DRUG SUPPLY

LABORATORY
CAPACITY

DATA MANAGEMENT

CASE MANAGEMENT

ART/Pre-ART
DELIVERY

Result
100%
95%
90%
100%
100%
67%
70%

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USAID/SMART TA
SUMMARY RESULT OF HIVQUAL AND SMART TA INDICATORS

TT

1
2

4
5
6

8
9
10
11
12

SMART TA
Last round result
Standard

Indicator

Proportion of medical record is more than 80%

of score used the patient chart review tool
Proportion of patients who newly registered at
the OPC in last 6 months are tested for CD4
within 15 days of enrolment
Proportion of pre-ARV patients who visit the
OPC regularly (according the national guideline
every 3 months and per appointment with
doctor)
Proportion of patients who were newly
registered at OPC was prescribed INH
Proportion of ARV patients visiting the OPC for
medication pick-up according to scheduled
appointment in the last visit
Proportion of ARV patients who are assessed
for medication adherence in the last visit
Proportion of patients were initiated ART within
15 days after qualification in last 6 months
Proportion of qualified HIV patients are
prescribed for Cotrimoxazole or DAPSONE for
the last visit
Proportion of patients are screened for TB in
the last medical visit
Proportion of patients are tested CD 4 at least 1
in last 6 months
Proportion of patients who still alive and on
treatment after 12 months on ART (NGI ID)
Proportion of patients retained in care after 12
months of registration (SMART TA
recommended ID)

80%

Present result

Difference

Pass or fail

80%

-1%

Pass

75%

81%

91%

-4%

Pass

75%

95%

81%

81%

Pass

-92%

Fail

80%
85%

92%

91%

-9%

Pass

95%

100%

100%

31%

Pass

65%

69%

27%

-69%

Fail

90%

96%

85%

-15%

Fail

80%

100%

99%

21%

Pass

85%

78%

85%

85%

Pass

85%

75%

75%

Fail

80%

63%

63%

Fail

SMART monitoring score

SMART TA classification

Improving site

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USAID/SMART TA

No

Issue

HUMAN RESOURCES
Integrated model: HTC Counselor
(Ms Hau) was not trained on ART
adherence, thus she cant support
Ms Nguyet ( OPC counselor).
STRUCTURE AND ACCESS

Send Ms Hau to join in ART

adherence training

TB Infection Control: Medical

mask available but not welldelivered to needed patients (TB
suspected/ coughing patients)

QI PDSA Activity #1
Plan: Implement active TB infection
control and prevention
Do:
- Triage nurse distributes medical
mask for new patients at their first
visit
- Counselor provides counseling
session for the TB
suspected/coughing patients to
understand the importance of
medical mask wearing.
See: After 1 month, the OPC counts
how many medical masks have been
distributed and if they are provided
appropriately for the TB
suspected/coughing patients. Triage
nurse leads discussion of data and
team provides feedback, solutions,
and plan for ongoing monitoring.
Act: Revise plan if needed

1.
B

1.

E
1

Person in
charge

HTC Counselor

Triage nurse,
counselor

Supporter

Other
sources

Deadline

Actual date
of
completion

Note

OPC chief

OPC Chief

HCM PAC
staff
monitor
infectious
control
procedures
and check
regularly

OPC Chief

HCM PAC

Nov,
2014

DRUG SUPPLY

There is lack of OIs (antifungal )

Solution

LABORATORY CAPACITY
No issues
DATA MANAGEMENT
Documentation: Three logbooks:
ART, pre ART, daily medical check
up are available but ART logbook

Make plan to allocate OIs drug

appropriately,
Counsel patients buy OIs in case OIs
are not available
Advocate patient use HI card

Triage nurse and OPC staff update

ART logbook as guideline

Pharmacist
Doctor
Counselor

Triage nurse,
counselor,
C&S

HCM PAC
staff to check
(Mr. Tien)

Dec,
2014

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USAID/SMART TA
is not updated
2

Documentation: Referral situation

is not recorded in patient chart
and log book ( successful or not)

CASE MANAGEMENT

1.

Patient Follow-up: Follow-up of

referral cases, patients late reexamination, poor treatment
adherence must be improved.

ART/ Pre-ARTDELIVERY
HIV Qual # 3 : Proportion of

newly registered patients

and eligible for IPT are
prescribed INH in the last 6
months due some reasons:
1.
-

Doctor forget to INH

prescription for eligible
patients
Patients dont want to
take INH since they have
inadequate knowledge
on IPT, take many kinds
of drug at the same times
and its side effects

Triage nurse should update referral

situation in pre ART and ART
logbook based on information from
ACIS and C&S team

Triage nurse

HCM PAC
staff to check
(Ms Thuong)

Dec,
2014

QI PDSA Activity #2
Plan: Increase the rate of retention
in care of the all the patients
including Pre-ART and ART
Do: Triage nurse records late reexamination, referral cases, phone
to them to remind for reexamination, confirm the successful
referral. Counselor provide
counseling session to the patients on
benefits of early treatment,
significance of treatment adherence,
etc; implementation of LTFU SOP
See: Check with the number of
patients who show late reexamination and poor treatment
adherence and see the records at
the record books.
Act: Continue with the action above
or change as appropriate.

Triage nurse,
counselor,
Care and
support team

HCM PAC
staff to check
( Ms Thuong)

Sep,
2015

QI PDSA # 3
Plan: Develop QI plan to increase
indicator 3
Do: Triage nurse remind doctor to
prescript INH for eligible patients
Doctor stick a note at visible place
for self-reminder
Pharmacist make appropriate plan to
ensure INH are available
Counselor encourage patients agree
to take INH when they were
prescribed INH
See: HIVQUAL staff lead discussion
during regular meeting of OPC
Conduct midterm review

QI team of
D9 OPC

HCM PAC
( Dr Ung)

1/2005

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USAID/SMART TA
There is not INH available

Proportion of
patients were initiated ART
within 15 days after
qualification in last 6 months
HIVQual # 6:

2.

due to some reasons:

- Doctor didnt review CD4 results
right after receiving,
- Nurse didnt record CD4 in
patient chart right after receiving
CD4 results
- Cant contact with patients when
they are eligible for ART initiation.
- Patients are not ready for ART
initiation

Act: Revise QI plan if any to ensure

target of QI is achievable
QI PDSA #4
Plan: Develop QI plan to increase
indicator 6
Do: Triage nurse should review CD4
count right after delivery, find out
who are eligible for ART initiation
and inform for doctor
Triage update phone number of pre
ART patients frequency
Counselor help patients ready for
ART initiation through counseling
and supporting
See: Review this implementation in
regular meeting and conduct
midterm review
Act: Based on result of review to
revise action plan

Qi team of
D9 OPC

HCM PAC
( Dr Ung)

1, 2015

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