Background Wacah primary hospital is located in Ethiopia 513 km away from the capital Tuberculosis is a major public health problem posing significant deleterious health impacts by affecting the productive segment of the population and resulting serious burden to the health system and exploiting the individual’s/household economy. Community TB detection plays crucial role to control its transmission in the community but our hospitals community TB detection rate is at 19%.

Objectives To increase our community TB detection rate from a baseline of 19% to 50% by the end of April 2019.

Methods 1. Refreshment course for HEW (health extension workers) were given 2. Sputum smear preparation: One big problem identified was patients were refusing to be referred because of the distance and lack of transport. So our change idea was to train HEW on how to prepare sputum smear slides for suspected patients, after the slides were prepared they bring it to the hospital. If patient is positive he will be recalled from the community to get treatment. 3. Flyers about sign and symptom of TB were prepared and deployed for the general public 4. Health education on Tb was given by nurses and Health officers for patients and attendants in the waiting areas twice a week.

Results we saw an increased number of community TB detection by HEW and we achieved our objective

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Abstract 24 Figure 1

Conclusions Almost all hospitals in developing area face problems and challenges, but more than half of them can be solved by using model for improvement and a creative change idea.