(LAB_PTCQI disaggregation HTS/POCT site)Number of HIV Testing Service (HTS) and Point-of-Care Testing (POCT) sites engaged in Continuous Quality Improvement (CQI) activities to achieve national certification (ETC.)

Export Indicator

Number of HIV Testing Service (HTS) and Point-of-Care Testing (POCT) sites engaged in Continuous Quality Improvement (CQI) activities to achieve national certification(ETC.)
What it measures

This indicator identifies which PEPFAR-supported HTS and POCT sites are, or are not, actively engaged in an international, national, or regionally-recognized process for CQI and demonstrating measured improvement towards accreditation.

A PEPFAR-supported HTS and POCT site is defined as:

HIV Testing Service (HTS) site:

A) A site that performs HIV rapid testing only

B) See HTC_TST

A POCT site is defined as:

A) The site performs testing near or at the place of interaction with the patient/client

B) The site performs testing in an environment which does not have a formalaboratory infrastructure.

C) Testing at the POCT site is performed by healthcare workers who may not be laboratorians.

Note: A laboratory and POCT may both be present at a facility site.

A HTS site or POCT site should be counted for engaged activities supported by a recognized external CQI or certification preparedness program which is a national or regionallyrecognized continuous quality improvement process towards meeting international standards. For the HTS and POCT sites , this would be a CQI program that uses the WHO/CDC Stepwise Process for Improving the Quality of HIV rapid testing (SPI-RT) or the WHO/CDC Stepwise process for Improving the Quality of HIV-Related Point-of-Care-Testing (SPI-POCT) Checklists to audit the testing sites. For both HTS and POCT sites, countries are encouraged to establish a certification process as part of the national continuous quality improvement program, while using the WHO/CDC SPI-RT or SPI-POCT Checklists as a standardized tool to assess the compliance level with a minimum set of quality standards.

Countries are encouraged to monitor the number of HTS and POC testing sites performing HIV-related testing as well as the capacity of these sites. This effort seeks to evaluate PEPFAR support for laboratory capacity that will provide access to high quality, rapid, affordable diagnostic tests for care, treatment, prevention, and surveillance of HIV/AIDS.

Participation in PT programs can help monitor and improve quality of HIV testing at the HIV testing sites. This indicator will encourage countries to implement the PT program if none exists, expand the PT program to cover all testing sites, and will help improve quality of diagnostic and monitoring testing at all sites. The PT program is not intended to be punitive; the PT data is used for targeted technical assistance and improving overall quality of testing.

Determine the following:

1. HTS or POCT site is performing HIV rapid testing, and or POCT for EID, HIV VL or TB

2. HTS or POCT site is participating in a PT program specific for each point-of-care test performed.

3. HTS or POCT site is achieving successful passing criteria on the most recent PT panel. If a site has multiply POCT or HTS service delivery points, all service delivery points must achieve a successful passing score.

Rationale

A. Number of HIV Testing Service (HTS) and Point-of-Care Testing (POCT) sites engaged in Continuous Quality Improvement (CQI) activities to achieve national certification.

B. Number of HTS and POCT sites which have been audited and achieved certification to quality standards set by recognized national programs.

C. Number of HTS and POCT sites performing HIV rapid testing or other POC test and participating in and passing Proficiency Testing (PT).

Numerator

Number of PEPFAR-supported HTS and POCT sites

a) Participating in or not participating in a CQI program to achieve certification.

b) Which have been audited, and the level of achievement towards certification.

c) Performing HIV rapid tests or other POCT test (Early Infant Diagnosis (EID), HIV viral load, and TB testing). If performing HIV rapid testing or POCT tests, number of HTS and POCT sites participating in and passing PT test for each of the tests.

Denominator

N/A

Calculation

Use the total reported in Q4 only.

Method of measurement

Site level data for all HTS and POCT sites to indicate enrollment and recognition in a CQI program are obtained from program records of the PEPFAR-funded partners. Site level documentation of being audited by an external auditing agency and scores to indicate if quality standards are meet and certification achieved.

Site level information of HIV rapid testing and POCT performed plus site level documentation of participation in a PT program and passing (satisfactory or successful) scores on the latest PT panel.

How to review for data quality:

Follow PEPFAR Guidance for data quality review as circulated in Q4 reporting guidance

Measurement frequency

Q4 only

Strengths and weaknesses

Numerator: Number of HTS and POCT sites

Participating in a continuous quality improvement (CQI) program to achieve certification

Yes No

Current status of this HTS/POCT site toward achievement of certification

Not Audited Externally audited and achieved a score of Level 0-1 (<40%-59%) Externally audited and achieved a score of Level 2-3 (60%-89%) Externally audited and achieved a score of Level 4-Certified (≥90%-Certified)

Type of test performed

HIV rapid testing , EID, HIV Viral Load, TB

For each type of test, Proficiency Testing (PT) participation and passing score

Does this PEPFARsupported HTS/POCT site participate in and successfully pass Proficiency Testing (PT) for either HIV rapid testing, EID, HIV VL, or TB:

1. Perform Test;

2. Perform Test and participate in PT,

3. Perform Test and passed PT,

4. NA for each of the testing categories not performed at the site

Description of Disaggregate

Yes for each of the testing categories performed at the site. No for the tests listed that are not performed at the site. N/A for sites where the test that are not performed.

Only applicable if specific test is performed. The most recent PT panel must be scored satisfactory to be counted as a passing score.

 

Denominator N/A

Further information

MER 1.0 to 2.0 Change

This indicator is a combination of LAB_PT and LAB_CQI, separated by the disaggregate 1) laboratory or blood bank OR 2) HTS or POCT

PEPFAR Support definition

DSD: Sites will be counted as receiving direct service delivery support from PEPFAR with provision of key staff, on-site mentoring, infrastructure, information systems, maintenance service, equipment, or commodities. TA-SDI: Sites will be counted as supported through

TA-SDI: when the point of service delivery receives support from PEPFAR that meets to improve the quality of services with trainings, mentoring, and services offered at a national or sub-national level.

DREAMS SNU Specific Guidance 

None