Manual for Male Circumcision under Local Anaesthesia

Male circumcision under local anaesthesia
Version 3.1 (Dec09)
Figure 9.2 The performance and quality improvement process 3
The performance and quality improvement process involves the
following steps.
• Define desired performance. In order for people to perform well,
they must know what they are expected to do. Performance
standards need to be set. Staff must know not only what their
duties are, but also how they are expected to perform them. The
desired performance should be realistic and based on common
goals, the expectations of the community and the resources
available. Examples of desired performance standards related to
male circumcision are:
• All clients over the age of 18 years must complete a written
informed consent form before undergoing male circumcision.
• Instruments used during a male circumcision procedure must
be decontaminated in 0.5% sodium hypochlorite solution for 10
minutes before being cleaned and sterilized.
• All clients undergoing male circumcision (and/or their parents)
should be counselled about HIV.
• Assess performance. The team should continually assess its
own performance in relation to how it is expected to perform. This
assessment can be done on a continuous basis informally, or
more formally at periodic intervals, by monitoring specific activities
and steps, conducting self-assessments or obtaining feedback
from clients. Using the above desired standards as examples,
performance assessment may show the following:
• 76% of clients over the age of 18 years completed a written
informed consent form before undergoing male circumcision (a
gap of 24%).
• Instruments used during male circumcision procedures were
decontaminated in 0.5% sodium hypochlorite solution for 10
3
Adapted from: Performance improvement framework, developed through a collaborative effort by members
of the Performance Improvement Consultative Group (PICG).
Record keeping, monitoring, evaluation and supervision Chapter 9-7