References in the content below refer to the PBMEF Guide.
Definitions
Existence of a continuous quality improvement (CQI) platform(s) at all levels of the health system for 1) TB clinical care, 2) TB laboratory, 3) TB commodities, and 4) other whereby TB service delivery and relevant data and indicators are systematically monitored, their quality assessed, and decisions are made to address any operational problems or challenges identified.
Numerator Information:
Existence of a continuous quality improvement (CQI) platform(s) at all levels of the health system for the following:
- TB clinical care CQI program? Yes/No
- TB laboratory CQI program? Yes/No
- TB commodities CQI program? Yes/No
- Other CQI? Yes/No (if yes, please describe)
CQI programs may take multiple forms; one example may be regular or systematic data review and monitoring meetings that NTPs conduct at district, provincial, and national levels where problems, gaps, bottlenecks, delays, etc. that impact patient care are assessed. Impacts on patient care could include impacts on case detection, treatment outcomes, TPT completion, etc., thereby encompassing multiple steps in the TB care and prevention cascade.
Numerator
Denominator
Ref # |
SN_CQI
|
Tier Level |
National Level Indicators
|
Category |
Sustain
|
Type |
Outcome
|
Unit of Measure |
Yes/No
|
Data Type |
Boolean
|
Disaggregations |
N/A |
Reporting Level |
National Level indicators should be reported at the national level; data may also be reported subnationally or at the project level if national data is not available.
|
Reporting Frequency |
This indicator should be reported on an annual basis at a minimum. More frequent monitoring on a quarterly or monthly basis is recommended.
|
Documented quality improvement processes and tools geared to increase and maintain quality implementation and performance (i.e., Reports of Laboratory QMS, procurement and supply chain QMS, pharmacy QMS, program audits).
“CQI is a progressive incremental improvement of processes, safety, and patient care. The goal of CQI may include improvement of operations, outcomes, systems processes, improved work environment, or regulatory compliance.” “CQI project development commonly includes defining the problem, benchmarking, setting a goal, then iterative quality improvement projects.”1 It is a means to determine and track program integrity and effectiveness. It is important because it guides quality operations; ensures safe environments and high quality of services; supports in meeting standards and regulations; and assists institutional programs and services to meet annual goals, objectives, and targets.
1 - O'Donnell B, Gupta V. Continuous Quality Improvement. [Updated 2023 Apr 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559239/
To pinpoint and address the gaps, analytical tools like run charts, fish-bone diagrams, and flow charts may be helpful. CQI processes are proactive, and methods are able to identify and remediate latent or future program challenges and requirements. CQI programs should use performance data to inform an iterative and incremental transition toward an optimally performing system by building on successes and improving suboptimal activities and outputs.
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