Measuring Quality Gaps in TB Screening in South Africa Using Standardised Patient Analysis
Christian, Carmen S ; Gerdtham, Ulf-Göran LU
; Hompashe, Dumisani
; Smith, Anja
and Burger, Ronelle
(2018)
In International Journal of Environmental Research and Public Health
15(4).
- Abstract
- This is the first multi-district Standardised Patient (SP) study in South Africa. It measures the quality of TB screening at primary healthcare (PHC) facilities. We hypothesise that TB screening protocols and best practices are poorly adhered to at the PHC level. The SP method allows researchers to observe how healthcare providers identify, test and advise presumptive TB patients, and whether this aligns with clinical protocols and best practice. The study was conducted at PHC facilities in two provinces and 143 interactions at 39 facilities were analysed. Only 43% of interactions resulted in SPs receiving a TB sputum test and being offered an HIV test. TB sputum tests were conducted routinely (84%) while HIV tests were offered less... (More)
- This is the first multi-district Standardised Patient (SP) study in South Africa. It measures the quality of TB screening at primary healthcare (PHC) facilities. We hypothesise that TB screening protocols and best practices are poorly adhered to at the PHC level. The SP method allows researchers to observe how healthcare providers identify, test and advise presumptive TB patients, and whether this aligns with clinical protocols and best practice. The study was conducted at PHC facilities in two provinces and 143 interactions at 39 facilities were analysed. Only 43% of interactions resulted in SPs receiving a TB sputum test and being offered an HIV test. TB sputum tests were conducted routinely (84%) while HIV tests were offered less frequently (47%). Nurses frequently neglected to ask SPs whether their household contacts had confirmed TB (54%). Antibiotics were prescribed without taking temperatures in 8% of cases. The importance of returning to the facility to receive TB test results was only explained in 28%. The SP method has highlighted gaps in clinical practice, signalling missed opportunities. Early detection of sub-optimal TB care is instrumental in decreasing TB-related morbidity and mortality. The findings provide the rationale for further quality improvement work in TB management. (Less)
- Abstract (Swedish)
- This is the first multi-district Standardised Patient (SP) study in South Africa. It measures the quality of TB screening at primary healthcare (PHC) facilities. We hypothesise that TB screening protocols and best practices are poorly adhered to at the PHC level. The SP method allows researchers to observe how healthcare providers identify, test and advise presumptive TB patients, and whether this aligns with clinical protocols and best practice. The study was conducted at PHC facilities in two provinces and 143 interactions at 39 facilities were analysed. Only 43% of interactions resulted in SPs receiving a TB sputum test and being offered an HIV test. TB sputum tests were conducted routinely (84%) while HIV tests were offered less... (More)
- This is the first multi-district Standardised Patient (SP) study in South Africa. It measures the quality of TB screening at primary healthcare (PHC) facilities. We hypothesise that TB screening protocols and best practices are poorly adhered to at the PHC level. The SP method allows researchers to observe how healthcare providers identify, test and advise presumptive TB patients, and whether this aligns with clinical protocols and best practice. The study was conducted at PHC facilities in two provinces and 143 interactions at 39 facilities were analysed. Only 43% of interactions resulted in SPs receiving a TB sputum test and being offered an HIV test. TB sputum tests were conducted routinely (84%) while HIV tests were offered less frequently (47%). Nurses frequently neglected to ask SPs whether their household contacts had confirmed TB (54%). Antibiotics were prescribed without taking temperatures in 8% of cases. The importance of returning to the facility to receive TB test results was only explained in 28%. The SP method has highlighted gaps in clinical practice, signalling missed opportunities. Early detection of sub-optimal TB care is instrumental in decreasing TB-related morbidity and mortality. The findings provide the rationale for further quality improvement work in TB management. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/f13d3416-ce16-40fc-a825-aecc80e887a5
- author
- Christian, Carmen S
; Gerdtham, Ulf-Göran
LU
; Hompashe, Dumisani
; Smith, Anja
and Burger, Ronelle
- organization
- publishing date
- 2018-04-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- quality of care, quality gaps, TB screening, standardised patients, South Africa
- in
- International Journal of Environmental Research and Public Health
- volume
- 15
- issue
- 4
- article number
- 729
- pages
- 10 pages
- publisher
- MDPI AG
- external identifiers
-
- scopus:85045375678
- pmid:29649095
- ISSN
- 1660-4601
- DOI
- 10.3390/ijerph15040729
- language
- English
- LU publication?
- yes
- id
- f13d3416-ce16-40fc-a825-aecc80e887a5
- date added to LUP
- 2018-04-14 08:50:11
- date last changed
- 2022-11-02 08:41:49
@article{f13d3416-ce16-40fc-a825-aecc80e887a5,
abstract = {{This is the first multi-district Standardised Patient (SP) study in South Africa. It measures the quality of TB screening at primary healthcare (PHC) facilities. We hypothesise that TB screening protocols and best practices are poorly adhered to at the PHC level. The SP method allows researchers to observe how healthcare providers identify, test and advise presumptive TB patients, and whether this aligns with clinical protocols and best practice. The study was conducted at PHC facilities in two provinces and 143 interactions at 39 facilities were analysed. Only 43% of interactions resulted in SPs receiving a TB sputum test and being offered an HIV test. TB sputum tests were conducted routinely (84%) while HIV tests were offered less frequently (47%). Nurses frequently neglected to ask SPs whether their household contacts had confirmed TB (54%). Antibiotics were prescribed without taking temperatures in 8% of cases. The importance of returning to the facility to receive TB test results was only explained in 28%. The SP method has highlighted gaps in clinical practice, signalling missed opportunities. Early detection of sub-optimal TB care is instrumental in decreasing TB-related morbidity and mortality. The findings provide the rationale for further quality improvement work in TB management.}},
author = {{Christian, Carmen S and Gerdtham, Ulf-Göran and Hompashe, Dumisani and Smith, Anja and Burger, Ronelle}},
issn = {{1660-4601}},
keywords = {{quality of care; quality gaps; TB screening; standardised patients; South Africa}},
language = {{eng}},
month = {{04}},
number = {{4}},
publisher = {{MDPI AG}},
series = {{International Journal of Environmental Research and Public Health}},
title = {{Measuring Quality Gaps in TB Screening in South Africa Using Standardised Patient Analysis}},
url = {{https://lup.lub.lu.se/search/files/41652323/ijerph_15_00729.pdf}},
doi = {{10.3390/ijerph15040729}},
volume = {{15}},
year = {{2018}},
}