P2B104: Development of an Interdisciplinary, Multi-country Quality Improvement Community of Practice (QICoP) to Foster Clinical Excellence Across the Texas Children’s Global Health Network (TCGHN)

Purpose/Objectives: Quality improvement (QI) has been embraced in global health settings as a strategy to improve patient outcomes, reduce costs, and enhance service delivery, with many countries integrating QI approaches into national strategic health plans and an emphasis on “access to quality essential healthcare services” in the United Nations Sustainable Development Goals. TCGHN is comprised of nine affiliated, independent non-governmental organizations with over 2,400 staff supporting healthcare services and delivery across nine low- and middle-income countries with flagship pediatric HIV clinical centers of excellence (COEs) in six countries in sub-Saharan Africa (SSA), and with technical support from Baylor College of Medicine (BCM). While discrete QI basics workshops had been offered previously, there had been no support for ongoing QI program development across TCGHN. The aim of this project is to determine the feasibility, acceptability, and uptake of an interdisciplinary, multi-country, virtual QI community of practice (QICoP) model to support Network-wide QI program development.

Design/Methods: In 2022 a group of QI and global health content experts convened to develop the QICoP concept. At the TCGHN annual conference, we conducted training on QI basics and program development and queried participants about the state of QI at their sites. During pre-planned, in-person clinical site assessments at five sites in SSA, we met with local QI committees to understand team composition, level of activity, resources, and to identify local champions. We utilized an existing virtual platform for cross-Network collaboration to launch the QICoP which allows for collaboration space and a virtual reference library. We hosted monthly virtual QICoP meetings and tracked attendance, participant evaluations, and organizer notes from each session.

Results: All sites were eager to participate in the QICoP. We recruited local representatives for the QICoP planning committee. Issues identified include the relevance of QI to their work; the need for refresher trainings, longitudinal mentorship, and project support; the desire to share learning; and the importance of adapting QI programming to the local context and national QI strategy. Participants noted support from BCM and collaboration and sharing of expertise across sites would enhance motivation for local QI teams. We have held three virtual QICoP meetings and participants expressed increased confidence in commencing QI programs. (See Table.)

Conclusion/Discussion: A QICoP is a promising model to support QI program development across a geographically dispersed network. It promotes a culture of improvement, adoption of evidence-based practices, multi-lateral knowledge sharing and alignment with national standards. Next steps are to continue monthly meetings, develop a curriculum to enhance basic QI skills with co-creation from local site champions, and identify QI mentors from BCM to work longitudinally with local teams. We will expand the reference library to include templates for terms of reference, planning tools, and QI projects from local sites.