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In-Patient Tuberculosis (TB) Treatment in Armenia: Establishment of Continuous Quality Improvement System

YEREVAN, Armenia – Starting in 2015, the Zvart Avedisian Onanian Center for Health Services Research and Development (CHSR) of the Gerald and Patricia Turpanjian School of Public Health collaborated with the National TB Control Center (NTCC) of the Ministry of Health and with financial support from the Armenian Medical Fund implemented the In-patient Tuberculosis (TB) Treatment in Armenia: Establishment of Continuous Quality Improvement System project. During the first phase of the project, the CHSR team conducted a thorough needs assessment of the NTCC’s diagnostic and inpatient treatment services in the TB inpatient facility located in Abovyan city. The project team used the Joint Commission International Accreditation Standards for Hospitals, International Standards for TB Care, and World Health Organization (WHO) framework for conducting TB programs review. The assessed facility is the largest TB hospital in the country that provides inpatient care to the majority of TB patients in Armenia.

During the needs assessment, the study team 1) reviewed and summarized the literature on quality assessment of inpatient TB facilities, 2) qualitatively explored practices of healthcare professionals working at NTCC and inpatient treatment experience of TB patients and their family members, 3) assessed the documentation, staff practices and environmental conditions of the NTCC’s inpatient facilities using standardized checklists, 4) evaluated the compliance level of TB diagnostic and treatment practices with internal policies and procedures, national and international guidelines and standards, and 5) made recommendations for establishing a continuous quality improvement system at the NTCC. At the end of the needs assessment, Dr. Armen Hayrapetyan, NTCC Director, suggested sharing the results with the NTCC team.

Within the month of March, the project team presented and discussed the findings of the needs assessment with the staff of the NTCC. CHSR researchers Zaruhi Grigoryan and Lusine Musheghyan made presentations to three separate groups of professionals from the NTCC with the goal of providing a general overview of methods and tools used for data collection and analysis and presenting the major findings of the needs assessment to those who participated and contributed to the project. Overall 30 participants, including representatives of the NTCC administration, heads of various departments, physicians and nurses took part in those discussions. The presentations were designed considering the relevance of the topics and specific interests of each group of professionals. These discussions gave the participants opportunity to share their opinions and thoughts regarding the findings with the study team from CHSR. Dr. Hratchia Lylozian (AUA MPH 2016), National Expert on TB services Quality Assurance and Research at NTCC, helped to organize the discussions.

The CHSR and NTCC management plan to continue the fruitful collaboration with the Armenian Medical Fund for the full implementation of the Continuous Quality Improvement System at NTCC.

The Gerald and Patricia Turpanjian School of Public Health works actively to improve population health and health services in Armenia and the region through interdisciplinary education and development of public health professionals to be leaders in public health, health services research and evaluation, and health care delivery and management.