Team PATA

What goals did the teams set at the 2011 PATA Summit?

Team Grid Analysis

At the 2011 PATA Pan-African Summit, 308 tasks were set by 38 treatment teams (three Rwandan teams worked together on one grid) to improve the quality

of care in their clinic. The team grids were coded and the data has been analyzed.

From previous PATA forums, we know that teams set tasks on the specific topics of the PATA forum and that these have considerably improved the quality of care that they are able to provide. As shown in the table below most of the tasks related to psychosocial support, 56% of these goals related to caring for adolescents, while the main focus of goals to improve diagnosis were targeted at infants (67%). This indicates that the information received in the plenary session on the day themes formed a key component of the team grid tasks for 2011/12.

The Aminu Kano Tertiary Hospital in Nigeria created a set of goals to improve adolescent care in their facility, this included dedicating a specific day to adolescents and drawing up a proposal to management to create an adolescent-friendly space.

The tasks chosen by teams are summarized under broad goals as indicated in the table below:

Goal	Count of tasks	Percentage
Psychosocial	140	45.45%
Capacity/Systems	84	27.27%
Diagnosis	37	12.01%
Adherence	20	6.49%
Staffing	13	4.22%
Infrastructure	12	3.90%
Pharmacy	1	0.32%
Nutrition	1	0.32%
Grand Total	308

As in previous years, many teams chose goals that involve a feedback session to their colleagues or management in their clinic through a CME, report or a special meeting. For instance the Songea team from Tanzania plans to "[debrief] the entire CTC staff and hospital management of the proceedings of the PATA Gaborone Forum 2011". Some teams go further and plan training on a specific topic addressed at the forum. The Sunshine Smiles Clinic in Kenya plans to equip caregivers and teachers with skills to deal with adolescents. This is what we call the "PATA effect". This feedback, training, mentorship and outreach comprises of 44% of the "Capacity/System" development goals.

It is quite interesting to look at the type of tasks that were chosen to improve care in PATA affiliated clinics. Tasks were classified by type as indicated below:

Some teams struggled to identify a concise task to address a goal. This is indicated by "undefined task". Often it is the teams that have not been involved in a PATA forum before that struggle with the team grid development. The graph above indicates that many of the tasks chosen to address clinic goals for the year, related to establishing new services, extending services or focusing on training and education. This is an example of how the forum acts as a "knowledge translation" exercise whereby teams put into practice the information and examples of best practice they are exposed to at the forum.

Day 3 of the programme focused on quality improvement, which included developing QI projects, data collection and measuring improvements. Many teams used this approach for their grid. For instance Thamaga team from Botswana aims to "improve early infant diagnosis from 70% to 90% in the next 6 months" which entails:

• Feedback to clinic management and the PMTCT focal person on the PATA Summit 2011
• Collect data on HIV positive mother and HIV exposed infants
• All HIV positive exposed children should have been tested

As mentioned, many of the teams focused on improvements relating to adolescent care. As shown in the table below over a third of the goals related to adolescents, 21.8% of the interventions related to the care of all the patients groups and 19.2% related to improving staff work, motivation and training. For instance the team from Rustenburg (RSA) plans to approach management so that there will be one permanent doctor for paediatrics instead of a rotating schedule.

Target group	Count of tasks	Percentage of tasks
Adolescents	109	35.4%
General Patients	67	21.8%
Staff	59	19.2%
Infant	30	9.7%
Child	14	4.5%
Community	13	4.2%
Teacher	11	3.6%
Expert Patients	4	1.3%
Men	1	0.3%
Total	308

Overall the greatest number of tasks set by clinics can be considered psychosocial interventions. These were to initiate new services for adolescents (31 of 78 tasks in this category) or expand services to adolescents (15 out of 78 possible goals), this is followed by staff training (10 of 78 goals).