1. ClASS MODULES: BREAKOUT SESSIONS

2. ClASS CLINICAL MODULE

3. Session Objectives By the end of the session, participants will be able to: List the 10 content areas within the ClASS Clinical Module Describe the structure and organization of the ClASS Clinical Module Explain how the tool may be used in its modular format Identify key resources from which to gather information Develop a plan for gathering information on-site Effectively present findings and recommendations

4. Section 1: Facility, Staffing & Services Section 2: Clinical Care & Oversight Management Section 3: Infection Control Section 4: Maternal, Infant, Child Health & Pediatric HIV Services Section 5: Referrals & Access to Relevant Services Section 6: Pharmacy & Supply Chain Management Section 7: Quality Improvement &Performance Monitoring Content Areas (1)

5. Section 8: Laboratory & Other Diagnostic Services Section 9: Client/Patient Involvement in Care Section 10: Health Management Information Systems Section 11: Clinical/Technical Capacity Section 12: Clinical/Technical Support Approaches Section 13: Clinical/Technical Support Outcomes Section 14: Ongoing Program Support: Critical Gaps and Technical Assistance Needs Content Areas (2)

6. Other Support Tools 1.Adult Chart Review 2.Pediatric Chart Review 3.PMTCT Chart Review

7. Structure and Organization (1)

8. Structure and Organization (2)

9. Document Review Advance ReviewOn-Site Review List of HIV care providers and role All Clinical Protocols and standard operating policies and procedures (including reproductive health and family planning). Opening and closing hours policy Patient Registers, patient medical charts and other monitoring forms. Infection control policies and proceduresPatient Consent Policies and Forms. HIV counseling and testing policiesPharmacy ledgers. Pharmacy Policies and SoP’sPatient referral policies, directory and tracking forms Patient Satisfaction Surveys tools and most recent Survey Results Continuing medical (professional) Education Attendance Records and or Proceedings. Emergency care policies and proceduresTrainings clinical staff has participated in last 12 mo. National HIV Care and Treatment Guidelines (Adult, Pediatrics, PMTCT, HCT, and etc.) Laboratory policies and standard operating procedures for absolute minimum tests (HIV antibody test and hemoglobin), basic tests (white blood cell count, serum creatinine, a serum glucose, and pregnancy tests), and (CD4). Quality improvement and assurance plan, protocols and committee minutes Policy documents on post exposure prophylaxis Laboratory QA and QC reports. Continuous Quality Improvement reports (STOCS/PDSA) Clinical charts (adult, PMTCT and pediatric HIV care and treatment)

10. Key Staff Interviews

11. Activity ClASS Clinical Review Scenarios  Gather relevant and accurate information  Prioritize and communicate findings

12. The ClASS Clinical Module is divided into 10 sections. Each section includes core competencies, a series of suggested questions and verification criteria. The ClASS Toolkit is modular in format, which means that modules or sections of modules may be chosen based on relevance to the program being assessed. This decision will be made by review team and collaborating partners. Reviewers should not feel required to complete the tool sections (or tools in general) in any specific order. Key Points

13. QUESTIONS?