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Table 1 Components of the SIMS intervention, specified according to the Template for Intervention Description and Replication (TIDieR) Checklist

From: A complex intervention to improve implementation of World Health Organization guidelines for diagnosis of severe illness in low-income settings: a quasi-experimental study from Uganda

SIMS components

Collaborative improvement meetings

Clinical performance audits and feedback

Clinical mentoring


To guide facility staff on implementing collaborative improvement plans

To assess how the Quick Check is applied in local practice settings and reinforce the need for high performance on specific quality indicators derived from the Quick Check

To guide clinicians on application of Quick Check in local practice settings


Systematic assessment of local resources for severe illness management, goal setting by facility stakeholders with external supervision, and group problem-solving

Comprehensive monitoring of clinical performance through daily medical record extraction, with mentored review of regular performance indicator reports

Bedside teaching rounds and mentored reviews of clinical cases; simulation sessions for medical ward teams

Who provides

Local champion

On-site data collectors and project manager

Visiting expert clinician


In person with all clinical, administrative, and support staff

Data collection using CommCare, an open-source data collection platform; comprehensive performance reports delivered to clinical leaders at each site via email; focused messages about specific performance indicators delivered to individual clinical staff via SMS

Shadowing at the bedside


At the hospital

At the hospital

At the hospital

When and how much

One hour twice a month

Email reports weekly

SMS weekly

One full day each month


We added a USD 1500 process improvement fund to enable facilities to act on improvement priorities.

The program manager developed reports and sent SMS using DHIS2, an open-source electronic health record platform approved by the Ministry of Health.



The clinical team used the pre-training facility assessment report to develop a work plan for quality improvement.

The clinical leader discussed the reports with staff during collaborative improvement meetings.


How well

At least monthly at all 4 sites, bi-monthly at 2 sites

As designed

Every 4–6 months

  1. Abbreviations: DHIS2 District Health Information System Version 2 (Oslo, Norway), SMS short messaging service