Table 2 Possibilities for further innovation
Existing innovation that have developed in the club model | Purpose | Transferability to other chronic diseases | Anticipated new challenges | Potential future innovation |
|---|---|---|---|---|
Services Delivery | ||||
Specialized clubs | Address special needs of patients (eg, families and adolescents) | Yes, transferable in some cases (eg. diabetes) | Other needs that could be addressed with separate clubs | Clubs for migrants, older people, sex workers etc. |
Quick-Pick-UP (QPUP) | Lengthy times at facilities and desire for even greater convenience and collection flexibility | Yes, transferable | Other pharmacy pick up models | Private pharmacies, dispensing machines, home delivery options, use of unique patient identifiers |
Community clubs | Improve community involvement, reduce stigma | Yes, transferable | Â | Decentralised community medication distribution |
Recruitment champion | Number of club members plateauing and reluctance to recruit | Yes, transferable | Club numbers vary across facilities | Roving club recruiter/mentors |
Health workforce | ||||
Task shifting of clinical care to HIV counsellors / CHWs extended to include moves for low-level pharmacy assistants | Initial task-shifting to CHWs because clinicians overburdened with stable patients; now need to ensure legal dispensing of medication and to relieve pharmacy staff. | Yes, transferable | Constant updates on clinical care issues needed | Creative training / mentoring of HIV counsellors / CHWs and of staff dispensing medication |
Medical Products | ||||
The ‘jump’ (the seasonal shift to a 4 month drug dispensing cycle over Christmas) | Seasonal migration of patients | Yes, transferable | Client push for 4 monthly visits/refills to become the norm | Annual script |
Electronic scripting for processing the volume of scripts for CDU | Time taken with manual scripting | Yes, transferable | Harmonising of the electronic scripting with the official Western Cape systems; Capacity and resources for a paperless system | Electronic transfers of scripts from pharmacies to CDU and integration of CDU system with pharmacy stocktaking systems |