The implementation of BroadReach Consulting Patient Retention Solution was used to empower health workers in facilities within the Ugu district of Kwa-Zulu Natal (KZN), South Africa as part of BroadReach's activities in support of the USAID APACE program. Two clinics were selected for implementation based on the size of the HIV patient population and the availability of staff to engage in reviewing clinical operations practices.

The project team visited the two sites to socialize the approach, review site processes and understand the operational impact. Input was received from data capturers, enrolled nurses, professional nurses and management to ensure there was a clear flow from insight to impact. Specific case management interventions were workshopped with the clinic staff, as well as the district director and sub-district manager of the KZN BR-APACE program. The project team also validated understanding of data fields used as part of the insights into operationalization of the results.

Key Learnings

• Understanding the end-user’s operating context is crucial to driving successful implementation and adoption of the technology.
• Customised patient retention interventions need to be designed & driven by the end-user; these should include pre and during appointment interventions.
• Adoption of model requires initial ‘hand-holding’ – include change management at the onset.
• Implementation needs to complement existing work flow within the program & facility.
• Identify field staff support upfront to ensure resource back-up.
• Develop a facility-level Standard Operating Procedure that is easy to follow.

Implementation process applied to this use case

Prevent patient loss to follow up to improve health outcomes

• Early identification of patients at risk of dropping off treatment
• Timeously intervene to prevent patients from defaulting on treatment
• Monitor effectiveness of patient retention interventions for ongoing improvement