Mejora del desempeño de hospitales en Guatemala, El Salvador, Costa Rica, Panamá y Belice

The project provided technical assistance to the Ministries of Health and/or Social Security of the five countries to strengthen the technical capacity of healthcare personnel and improve access to services for people living with HIV. The methodology used was Optimizar el Desempeño y la Calidad, a management strategy to improve healthcare processes and performance. This approach systematically and continuously applied operational standards based on best practices, evidence-based medicine, national norms, and protocols for HIV/AIDS, as well as user satisfaction perception, which is the center of the quality system. The methodology was implemented in 76 hospitals in the region, working with local multidisciplinary teams that acquired technical competencies in implementing the ODC1 methodology in hospitals and clinics providing comprehensive HIV/AIDS care. The project's goal was to facilitate a performance above 85%. Costa Rica had the highest number of services with scores equal to or above 85% (7 services), but hospitals that started in the early years showed a decrease in average scores due to supply shortages and equipment, affecting the overall average. In Guatemala, the first four measurements showed a sustained growth, but the last two measurements showed a decline in the average score of hospitals in the fifth year due to the health system crisis, which led to labor stoppages, lack of medication and equipment, and high rotation of key personnel, affecting the continuous improvement system. The teams of quality in each hospital were trained in the implementation of the ODC methodology, which includes conducting periodic internal measurements, data analysis, resource management, and monitoring of the implementation plan to close gaps. The teams also developed manuals and operational guidelines for quality, as well as a general description of the decisions to be taken, which involve the management of the continuous quality process.