Gillian Dougherty, MPH, BSN, is the Senior Quality Improvement Technical Advisor, ICAP at Columbia University, Columbia University Mailman School of Public Health, New York, New York, USA. Rodrigo Boccanera, MPH, is a Project Officer, U.S. Health Resources and Services Administration (HRSA), Department of Health and Human Services, in Bethesda, Maryland, USA. Mary Adetinuke Boyd, MD, is the Deputy Director, U.S. Centers for Disease Control and Prevention (CDC), Lusaka, Zambia. Tracey Gantt, MSN, RN, APHN-BC, is a Project Officer, U.S. Health Resources and Services Administration (HRSA), Department of Health and Human Services, Bethesda, Maryland, USA. Siphiwe Chilungu Kasonka, MPH, is the Senior M&E Advisor, ICAP Zambia, Lusaka, Zambia. Prisca Kasonde, MD, MPH, is the Country Director, ICAP Zambia, Lusaka, Zambia. Nila Kaetano, BSN, is the QI Advisor, ICAP Zambia, Lusaka, Zambia. Caitlin Madevu-Matson, MSc, is the Informatics and Data Use Manager, ICAP at Columbia University, Mailman School of Public Health, New York, New York, USA. Phales Milimo, MS, is the QI M&E Officer, ICAP Zambia, Lusaka, Zambia. Mukuka Mwamba, MSc, Dip Pharmacy, is the QI Project Director, ICAP Zambia, Lusaka, Zambia. Milembe Panya, MD, MPH, is the Regional Quality Improvement Advisor, ICAP Tanzania, Dar es Salaam, Tanzania. Brenda Senyana, MPH, is the M&E Advisor, ICAP at Columbia University, Mailman School of Public Health, New York, New York, USA. Fatima Tsiouris, MSc, is the PMTCT Senior Technical Advisor, ICAP at Columbia University, Mailman School of Public Health, New York, New York, USA. Lauren Walker, MPH, is the Senior Project Officer, ICAP at Columbia University, Mailman School of Public Health, New York, New York, USA. Nancy Zyongwe, MD, is the QI Advisor, Zambian Ministry of Health (MOH), Lusaka, Zambia. Alice Zulu, MD, is the QI Advisor, ICAP Zambia, Lusaka, Zambia. Miriam Rabkin, MD, MPH, is the Director of Health Systems Strategies, ICAP at Columbia University, Mailman School of Public Health, New York, New York, USA.
J Assoc Nurses AIDS Care. 2021;32(6):701-712. doi: 10.1097/JNC.0000000000000268.
HIV testing with rapid antiretroviral therapy (ART) initiation are life-saving interventions for adolescents living with HIV. However, in Zambia, HIV diagnosis and immediate ART initiation among adolescents living with HIV is lagging. In collaboration with the Zambian Ministry of Health, the U.S. Health Resources and Services Administration, the U.S. Centers for Disease Control and Prevention in Zambia, and ICAP at Columbia University designed and implemented a quality improvement collaborative (QIC) to improve adolescent immediate ART initiation at 25 health facilities in Lusaka. Over the 12-month implementation period, quality improvement teams tested and identified targeted intervention, that significantly improved ART initiation within 14 days of receiving positive test results, from 24% at baseline to more than 93% for the final 6 months of implementation. The quality improvement collaborative approach empowered health care workers to innovate addressing the root causes of suboptimal performance and produced a package of successful interventions that will be shared throughout Zambia.
艾滋病毒检测和快速抗逆转录病毒治疗（ART）的启动是挽救感染艾滋病毒青少年生命的干预措施。然而，在赞比亚，艾滋病毒诊断和感染艾滋病毒的青少年立即开始接受抗逆转录病毒治疗的工作严重滞后。在美国卫生资源和服务管理局、美国疾病控制和预防中心在赞比亚的合作下，以及哥伦比亚大学的国际疫苗中心，设计并实施了一项质量改进合作（QIC），以改善卢萨卡 25 个卫生机构中青少年的即时 ART 启动率。在 12 个月的实施期间，质量改进团队进行了测试并确定了有针对性的干预措施，这大大提高了在收到阳性检测结果后 14 天内开始接受 ART 治疗的比例，从基线时的 24%提高到实施的最后 6 个月的 93%以上。质量改进合作方法使卫生保健工作者能够创新解决表现不佳的根本原因，并制定了一整套成功的干预措施，将在赞比亚各地分享。
