TA PLAN FORM (v 4.8.14.

0)
USAID/SMART TA
ASSESSMENT PERIOD

1/10/2013

To

DATE OF ASSESSMENT

10/9/2014

SITE INFORMATION

OPC Binh Thanh

30/6/2014

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

Ethnic group clients

% total clients)
%

Total clients under management:

% total clients)

1831 (129 Pre-ART/ 1702 ART)

HUMAN RESOURCES
Full-time: 3
Part-time: 10
Total: 13

Name

Position

Trung

OPC chief,
doctor
Treatment
doctor
Nurse,
secretary
Counselor
Pharmacist

Dong,
Phuong
Hoang,
Hong
Nga, Thu
Binh

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

Name of OPC chief

Dr. Le Dien Trung

Contracted
Part-time
Full time

Gov
Part-time Full-time
x
x

x
x

Name of PAC
representative

File assessment data

Pham Thi Mong Thuong

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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
92%
97%
90%
100%
100%
67%
70%

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TA PLAN FORM (v 4.8.14.0)

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

No

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

100%

69%

Pass

75%

31%

94%

94%

Pass

75%

0%

95%

95%

Pass

0%

-97%

Fail

80%
85%

97%

95%

-3%

Pass

95%

98%

98%

41%

Pass

65%

57%

75%

-25%

Pass

90%

100%

68%

-27%

Fail

80%

95%

86%

15%

Pass

85%

71%

100%

100%

Pass

85%

88%

88%

Pass

80%

86%

86%

Pass

SMART monitoring score

SMART TA classification

Improving site

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TA PLAN FORM (v 4.8.14.0)

USAID/SMART TA

No

Issue

HUMAN RESOURCES
Staffing for transition phase: HCM
PAC and PMC Binh Thanh should
have plan to change contract staff
in the next SA

1.

Solution

QI PDSA Activity #1
Plan: Develop a staffing plan for Binh
Thanh with involvement of PAC
HCM,PMC, FHI
Do:
- Organize a meeting among
stakeholders to get agreement
and commitment
- PAC, PMC, FHI allocate budget
for staffing as plan
See: Reflection in biannual meeting
and revised intervention plan if any
Act: Implement the revised plan

Send Dr.Phuong to attend MMT

training
2.

Training: Part time doctor (Dr.

Phuong) was not trained on MMT

3.

Triangle nurse has lack of

computer skill

4.

Training: MMT counselor was not

trained on VTC and adherence

Other doctor support Dr Phuong at

site
Other staff will support her to fulfil
this role
Send MMT counselor to attend basic
and advanced HTC & adherence
training
Other staff support MMT counselor
through daily work

Supporter

Other
sources

Deadline

Actual date
of
completion

Note

OPC Binh
Thanh

PMC Binh
Thanh
PAC HCM

PAC HCM
Dr. Phuong
OPC chief & Dr
Dong
M&E staff ( Ms
Phuong)
OPC chief
Adherence
counselor
Other OPC
staff

FHI 360

31/12/20
14

OPC chief

OPC chief

12, 2014

PMC director
OPC Chief

PAC HCM
FHI 360

31/12/20
14

OPC Chief

HCM PAC
staff
monitor
infectious
control
procedures
and check
regularly

Dec,
2014

STRUCTURE AND ACCESS

-

1.

Person in
charge

TB Infection Control: there is no

separate area of waiting room for
cough /suspected TB patients

TB suspected/ cough
patients should priority to
check up
Educate patients remember
wear mask at every visit
Conduct a meeting to
restructure the waiting area
to ensure there is a
separate area for

Triangle nurse,
counselor

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TA PLAN FORM (v 4.8.14.0)

USAID/SMART TA

No

Issue

Solution

Person in
charge

Supporter

Other
sources

Deadline

Actual date
of
completion

Note

cough/suspected TB
patients
C

DRUG SUPPLY
There is lack of shelf to store drug

D
E
1

There is no temperature
monitoring log
LABORATORY CAPACITY
No issues
DATA MANAGEMENT
Documentation: Two logbooks:
ART, pre-ART are updated
appropriately, but daily logbook
was not

Status of referral cases are not

updated

CASE MANAGEMENT

1.

Patient Follow-up: Patients late

re-examination, poor treatment
adherence must be improved.

Buy new shelves and re

order drug properly
Update temperature
monitoring log twice a day

OPC staff should update daily

logbook frequently
Follow up referral case to ensure
they are successful transferred.
Then, case manager should update
in transfer logbook

QI PDSA Activity #2
Plan: Increase the rate of retention
in care of the all the patients
including Pre-ART and ART
Do: Extends working time (6h00 to
19h30- 2 days/week) to help
patients can visit OPC after their
works, no need to take leave
anymore.
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.

Pharmacist
Pharmacist

Case manager
nurse ( Ms
Hong)

M&E staff ( Ms
Phuong)

Triage nurse,
counselor,
Care and
support team

OPC chief

HCM PAC

Dec 2014

OPC chief

HCM PAC

Nov 2014

Triangle
nurse
OPC chief

Dec,
2014

Case manager
nurse
Treatment
doctor

Dec,
2014

HCMPAC staff
to check

Dec,
2014

ART/ Pre-ARTDELIVERY

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TA PLAN FORM (v 4.8.14.0)

USAID/SMART TA

No

Issue

Proportion of
newly registered patients
and eligible for IPT are
prescribed INH in the last 6
months due some reasons:

Solution

Person in
charge

Supporter

Other
sources

Deadline

Actual date
of
completion

Note

HIV Qual # 3 :

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
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

Doctor remember to INH

prescription for eligible
patients
Counselor provide counsel
for patients about benefits
of INH
Allocate of INH property

QI PDSA Activity #3
Plan: Develop QI plan to increase
indicator 6
Do: Triangle nurse should review
CD4 count right after delivery, find
out who are eligible for ART
initiation and inform for doctor
Triangle 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

Doctor
Pharmacist
Nurse

HCM PAC
OPC Binh
Thanh

PAC HCM
OPC staff

Dec,
2014

FHI 360

Dec,
2014

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