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The purpose of this paper is to describe the authors’ experience operationalizing the care delivery value chain (CDVC) as a management and continuous quality improvement (QI) approach to strengthen HIV/AIDS services provided in Northern Togo through addressing gaps across a care continuum.

The authors led a series of discussions to develop a CDVC specific to existing HIV/AIDS services in Northern Togo. Using the CDVC framework, 28 specific gaps in service delivery were identified and integrated into a strategic QI plan.

At 12 months, 92 percent of delivery gaps had demonstrated improvement. The CDVC framework proved to be valuable in the following ways. First, it facilitated the first comprehensive mapping of HIV/AIDS services in the Kara region of Togo. Second, it enabled the identification of gaps or insufficiencies in the currently available services across the full continuum of care. Third, it catalyzed the creation of a strategic QI plan based on identified gaps.

This case description is the authors’ experience in one setting and should not be considered comparative in nature. Furthermore, the approach described may not be applicable to all initiatives and/or organizations. As described, the lack of sophisticated and comprehensive data collection systems limited the authors’ ability to collect reliable data on some of the QI initiatives planned.

The operationalization of the CDVC framework is an effective approach to drive continuous QI.

Through the operationalization of the CDVC, the authors developed a new approach for assessing existing services, identifying gaps in service delivery and directing continuous QI initiatives in a strategic manner.

The study aims to describe the impact of supervisor’s and co-worker’s ostracism on the employee's responses (emotional, psychological and behavioral) through the mediation of employees' efficacy needs and relational needs. Moreover, psychological capital is treated as a moderator to handle the adverse responses of ostracized employees.

The study employed a three-wave quantitative research design to gather data from employees and their respective supervisors who belonged to various healthcare units (N = 510) using self-administered close-ended questionnaires. After that, SmartPLS software was used to analyze the data through a structured equation modeling (SEM) technique.

The empirical results of the study endorsed that ostracism adversely (negatively) affects employees' responses (comprised of emotional, behavioral and psychological). Moreover, the results revealed that employees' needs (efficacy and relational) mediate the relationship between ostracism experienced by employees (supervisor’ and co-workers’ ostracism) and their emotional, behavioral and psychological responses. In addition, it is also evidenced that employees' psychological capital improves the negative association between employees' needs and responses.

The literature in this domain is scarce, and the theoretical stance is weak due to the traditional approaches that are more concerned with the outcomes rather than analyzing the employee's conditional what they are going through. The present study enhances the knowledge of the transactional mode of coping and its application to ostracism in the workplace. The results of the current study may also support the practitioners in formulating interventions to foster a favorable workplace environment.