The African Field Epidemiology Network (AFENET) in collaboration with the Center for Disease Control and Prevention (CDC) and Ministry of Health (MOH) in Uganda has launched the TB Clinic-Lab Interface Continuous Quality Improvement (CLICQ!) ECHO program. This program guides and enables healthcare workers and laboratory staff to review their clinic-laboratory data as well as identify gaps within their patient cascade. Patient cascades ensure that, each patient diagnosed with TB is enrolled on a 'pathway' of management to ensure a seamlessly extends from the prehospital and ED phases to the ICU and rehabilitation services if required.
With the newly launched CLIQ! program, participants attend learning sessions to receive training on continuous quality improvement (CQI) practices, data review, and other strengthening activities. Site-specific improvement projects are developed that target prioritized gaps for closure. A metric-based monitoring and evaluation plan is developed, in parallel with the improvement projects, to track on-site progress of improvement projects. The program aims to build the capacity of national, and facility-level staff to improve data usage and address site-specific gaps that will be identified within the patient pathway, or diagnostic cascade.
AFENET will roll out this program in twelve health facilities in the Bunyoro and Lango sub regions in Uganda. All these facilities will be assessed using the Diagnostic Cascade Evaluation (DiCE) tool to identify challenges / gaps present within their TB diagnostic and treatment cascade. The DICE toolkit will serve as a guide for the abstraction and automated analysis of above-site and/or site-level data for each step within the diagnostic cascade, from patient presentation to TB treatment outcome, when and where data is available. The facilities will then be randomized into two arms with some facilities receiving mentorship through the ECHO program and the other facilities receiving onsite mentorship on the improvement projects these sites decide to track. The DICE check list (DiCE) will be used as a tool for entry and exit assessments at sites enrolled in the CLICQ!-ECHO program. The DiCE entry and exit assessment results will be compared to calculate CLICQ! program impact over time.
AFENET Lab Teams at Ndejje Health Center IV, to launch the TB Clinic-Lab Interface Continuous Quality Improvement (CLICQI) ECHO program.