Investigation of the sequential validity of quality improvement team self-assessments in a health facility HIV improvement collaborative in Tanzania

Abstract

Background: Self-assessment is widely used in the health care improvement collaboratives quality improvement (QI) teams’ to assess their own performance. There is mixed evidence on the validity of this approach. This study investigated sequential validity of self-assessments in a QI HIV collaborative in Tanzania.

Objectives: Define the separate self-assessment steps in QI process; determine if the validity of self-assessments improved over time; determine if validity improvement is the same for the different self-assessment activities and determine if validity is the same for the different facilities and type of care.

Design: Prospective semi-quantitative study.

Setting: The study was undertaken over 10 months in nine facilities in Mtwara region of Tanzania following appropriate approvals. Study did not interfere with routine services and processes of continuous quality improvement at the facilities.

Subjects:Trained investigators retrieved information from records and the computers using data capture forms. Patients of service providers were not questioned or participate in the study.

Conclusion:The validity of self-assessments in the HIV/ART/PMTCT Improvement Collaborative in Mtwara region of Tanzania improved as the collaborative matured. Data from computerised data bases unreliable, calling for more training in the use of computers. The weakness in communication should be addressed by collaborative designers and coaches.