dc.contributor.author | Christian, Carmen S. | |
dc.contributor.author | Gerdtham, Ulf-G. | |
dc.contributor.author | Hompashe, Dumisani | |
dc.contributor.author | Smith, Anja | |
dc.contributor.author | Burger, Ronelle | |
dc.date.accessioned | 2018-04-24T14:01:06Z | |
dc.date.available | 2018-04-24T14:01:06Z | |
dc.date.issued | 2018 | |
dc.identifier.citation | Christian, C. S. et al. (2018). Measuring quality gaps in TB screening in South Africa using standardised patient analysis. International Journal of Environmental Research and Public Health, 15: 729. | en_US |
dc.identifier.issn | 1660-4601 | |
dc.identifier.uri | http://dx.doi.org/10.3390/ijerph15040729 | |
dc.identifier.uri | http://hdl.handle.net/10566/3608 | |
dc.description.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. | en_US |
dc.language.iso | en | en_US |
dc.publisher | MDPI | en_US |
dc.rights | © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access
article distributed under the terms and conditions of the Creative Commons Attribution
(CC BY) license (http://creativecommons.org/licenses/by/4.0/). | |
dc.subject | Quality of care | en_US |
dc.subject | Quality gaps | en_US |
dc.subject | TB screening | en_US |
dc.subject | Standardised patients | en_US |
dc.subject | South Africa | en_US |
dc.title | Measuring quality gaps in TB screening in South Africa using standardised patient analysis | en_US |
dc.type | Article | en_US |
dc.privacy.showsubmitter | FALSE | |
dc.status.ispeerreviewed | TRUE | |