ECHO Session Videos

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ECHO Session Summaries and Presentations

May 2018:
Dr Miriam Rabkin from ICAP at Columbia University, Caroline Caren Ayieko of the Siaya County Health Management Team in Kenya, and Dr Limbikani Kanyenda from University Research Company in Malawi and Dr Michael Odo from the Malawi Ministry of Health discussed result utilization of differentiated care models, whereby viral load test results serve to triage patients needing intensified care (in cases of unsuppressed viral load) and patients needing less intensive follow-up at the community level (in cases of suppressed viral load). Kenya and Malawi shared their experiences implementing the ‘Plan, Do, Study, Act’ (PDSA) cycle to prioritize and rapidly test ‘change ideas’ needed to facilitate the rapid identification of unsuppressed viral load, followed by swift appropriate clinical action. Some of the most successful solutions identified included the development of standard operating procedures for the management of unsuppressed viral load, color-coding of files for patients with unsuppressed viral load, appointing viral load focal persons at the facility level, assigning case managers to clients with unsuppressed viral load, forming  unsuppressed viral load support groups, appointing second-line antiretroviral therapy champions, and mentoring staff about enhanced adherence counselling. The application of ‘change ideas’ identified during the quality improvement process led to an increasing proportion of patients with unsuppressed viral load who completed 3 enhanced adherence counselling sessions – from 50% to 90% within four months.

Guidelines and best practices to inform patients about the significance of viral load results and ensure that laboratory test results fully contribute to patient clinical management are available at http://icap.columbia.edu/resources/detail/viral-load-toolkit-flipcharts.

Download VL Diagnostic Testing Service Delivery in Kenya

June 2018: LARC
Laboratory results utilization is a key component of the viral load (VL) cascade if patient management is to be improved. Homabay County Referral Hospital in Kenya identified that despite a short turnaround time for Vl test results., these results did not end up in patients’ files, compromising the benefit of VL monitoring. The Laboratory African Regional Collaborative project (LARC) project supported clinicians, laboratorians and data record units to work together and improve the proportion of Vl test results put in patients’ files from 4% to 80% in seven months. This remarkable achievement was shared by PatriciaRiJeyfrom ILB CDC and Winnie Shena from Kenya during the LabCoP ECHO session of June 2018.

LARC is a useful tool that can be used by countries to address inefficiencies at the laboratory-clinical interface at clinic level, and achieve the 3rd
’90’ of the UNAIDS 90·90-90H1Vtargets.
You can download the LARC workbook here.