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Shift Work Caribbean Sub

How can the science of improvement remove systemic barriers to improve treatment for people living with HIV?


Despite strong healthcare capacity, systemic barriers and stigma prevent health care provider teams from executing care for patients living with HIV. Routine blood tests are critical to monitor the health of people living with HIV and to tailor antiretroviral therapy. Building on the existing investment in training and capacity development, the Caribbean Regional Quality Improvement Collaborative (CaReQIC) seeks to empower frontline health care workers to partner with people living with HIV to implement best practices and improve quality of care. CaReQIC is a multi-country network ensuring that new and existing treatment sites address systemic barriers that could impact upon the quality of care.

Their perspectives and experiences have been critical to the network’s success.

our approach

Shift provided technical guidance and support to design and launch the improvement network which started as a small pilot and ultimately scaled to span four countries. Our organization also supported the development of a strategy to engage the people most impacted by the network’s efforts — people living with HIV. Their perspectives and experiences have been critical to the network’s success. Over the course of several years, Shift team members built the capacity of local organizations and government staff to lead the project which has led to sustained QI capacity in the region. An example of this sustained capacity is the Patient Advocate Mission, a locally registered NGO founded by Conrad Mitchell, a patient advocate whose leadership established the patient voice as a critical component of quality healthcare improvement in Trinidad and Tobago.



International Training & Education Center for Health at the University of Washington

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