Using the PDCA cycle to improve cervical cancer screenings at an HIV clinic

Background: Federally funded HIV programs are under increasing pressure to monitor and evaluate their adherence to the standards of care established by the Department of Public Health and Human Service Guidelines. Monitoring compliance with referral services, such as cervical cancer screenings, present a challenge to HIV specialist, yet is critical in measuring and ensuring that women living with HIV/AIDS are receiving the best standards of HIV care. Methods: Quality improvement staff reviewed charts of all female clients seen at the clinic during a 12-month period for documentation that cervical cancer screenings had been done. A compliance score was calculated by dividing the total number of female clients whose chart contained documentation that a screening had actually been done by the total number of female clients seen during the measurement period and then multiplying it times 100. Results of the performance review were shared with clinic staff and then used to facilitate a series of interactive, instructor-led trainings on performance measurement, quality improvement (QI) and use of the PDCA cycle to test change and improve performance. Results: Upon completion of the QI series and application of PDCA cycle to test change, staff was able to develop and test new strategies for tracking, monitoring and improving cervical cancer screenings of patients at their clinic. Conclusions/Implications: When used in conjunction with performance measurement results, the PDCA cycle can accelerate change and facilitate quality improvement.