Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02215, USA.
Int J Qual Health Care. 2011 Jun;23(3):231-8. doi: 10.1093/intqhc/mzr006. Epub 2011 Mar 26.
To assess health-care worker (HCW) awareness, interest and engagement in quality improvement (QI) in HIV care sites in Tanzania.
Cross-sectional survey distributed in May 2009.
Sixteen urban HIV care sites in Dar es Salaam, Tanzania, 1 year after the introduction of a quality management program.
Two hundred seventy-nine HCWs (direct care, clinical support staff and management).
HCW perceptions of care delivered, rates of engagement, knowledge and interest in QI. HCW-identified barriers to and facilitators of the delivery of quality HIV care.
Two hundred seventy-nine (73%) of 382 HCWs responded to the survey. Most (86%) felt able to meet clients' needs. HCW-identified facilitators of quality included: teamwork (88%), staff communication (79%), positive work environment (75%) and trainings (84%). Perceived barriers included: problems in patients' lives (73%) and too few staff or too high patient volumes (52%). Many HCWs knew about specific QI activities (52%) or had been asked for input on QI (63%), but fewer (40.5%) had participated in activities and only 20.1% were currently QI team members. Managers were more likely to report QI involvement than direct care or clinical support staff (P < 0.01). No difference in QI involvement was seen based on patient load or site type.
HCWs can provide important insights into barriers and facilitators of providing quality care and can be effectively engaged in QI activities. HCW participation in efforts to improve services will ensure that HIV/AIDS quality of care is achieved and maintained as countries strive for universal antiretroviral access.
评估坦桑尼亚艾滋病毒护理点卫生保健工作者（HCW）对质量改进（QI）的认识、兴趣和参与度。
2009 年 5 月进行的横断面调查。
坦桑尼亚达累斯萨拉姆的 16 个城市艾滋病毒护理点，在引入质量管理计划 1 年后。
279 名 HCW（直接护理、临床支持人员和管理人员）。
HCW 对提供的护理的看法、参与率、QI 知识和兴趣。HCW 确定的提供优质艾滋病毒护理的障碍和促进因素。
在 382 名 HCW 中，有 279 名（73%）对调查做出了回应。大多数（86%）认为能够满足客户的需求。HCW 确定的质量促进因素包括：团队合作（88%）、员工沟通（79%）、积极的工作环境（75%）和培训（84%）。感知到的障碍包括：患者生活中的问题（73%）和工作人员太少或患者太多（52%）。许多 HCW 了解特定的 QI 活动（52%）或被要求提供 QI 投入（63%），但较少（40.5%）参与了活动，只有 20.1%的人目前是 QI 团队成员。管理人员比直接护理或临床支持人员更有可能报告参与 QI（P<0.01）。根据患者负荷或站点类型，QI 参与情况没有差异。
HCW 可以为提供优质护理的障碍和促进因素提供重要见解，并可以有效地参与 QI 活动。HCW 参与改善服务的努力将确保在各国努力实现普遍获得抗逆转录病毒治疗的情况下，实现和维持艾滋病毒/艾滋病的护理质量。
