Quality Improvement Activities

The Fort Lauderdale/Broward EMA staff recently completed the HRSA Ryan White Care Act funded National Quality Center (NQC) Training-of-Trainers (TOT) Program developed to:

• Develop qualified HIV care Quality Improvement trainers

• Spread quality management concepts by increasing training opportunities

• Build quality management capacity in Ryan White-funded programs

• Increase confidence in facilitating QI training in HIV care environments

• Increase mastery of QI principles and their application in HIV care

• Understanding and mastery of adult learning theories

• Understanding of QI and QM training workshop development

• Planning action steps based on acquired training knowledge and skills

The QA staff is now implementing post TOT training activities. The EMA’s QM program is seeking subgrantee staff interested in participating in self-directed QI learning activities and applying subsequent knowledge to improving quality HIV care at their agencies. Quality of Care in Part A funded services is ultimately the responsibility of the Grantee. This is a unique challenge for Part A in comparison other Parts such as C and D where the Grantee is also the provider of care and manages the staff providing services. Part A Quality Improvement activities have as their goal improved overall HIV care across providers. Part A Grantees must address both system level and agency specific improvement opportunities. The Grantee is developing innovative ways to provide coordinate quality activities and support providers. One examples of this is establishing a QI Leadership Institute comprised of subgrantee staff desiring to be a part of a quality learning community.

HAB Core Clinical Performance Measures

The HAB HIV/AIDS Core Clinical Performance Measures for Adults & Adolescents: Group 1 represents the first five (5) core clinical performance measures that are deemed critical for HIV programs to monitor. These measures can be used by all programs funded by the Ryan White HIV/AIDS Program and can be used either at the provider or system level. Grantees are encouraged to include the core clinical performance measures in their quality management plans. While data are not required to be submitted to HAB at this time, grantees are strongly encouraged to track and trend data on these measures to monitor the quality of care provided. Grantees are encouraged to identify areas for improvement and to include these in their quality management plans.

This type of information can provide rich discussion opportunities with HAB Project Officers. To assist grantees in the use and implementation of the core clinical performance measures, a companion guide has been developed: HAB HIV Core Clinical Performance Measures for Adults & Adolescents:

FAQ at: http://hab.hrsa.gov/special/habmeasures.htm#draft3

Measures:

• ARV Therapy for Pregnant Women

• CD4 T-Cell CountHAART

• Medical Visits

• PCP Prophylaxis

Patient Satisfaction Survey

As part of its continuing efforts to improve the quality of services for HIV+ consumers, the Clinical Quality Assurance Support Program will conduct a test of the process of administering a Patient Satisfaction Survey (PSS) at one service provider’s site in order to anticipate what potential difficulties or barriers may be encountered when the PSS is rolled out to all service provider sites. Testing is scheduled for late May, with results available to the provider by early Summer. After adjustments are made to correct any problems or logistical issues, the full PSS will be conducted in late Summer or early Fall.

The PSS will be conducted in accordance with the PSS for HIV Ambulatory Care developed by the AIDS Institute of the New York State Department of Health, which has validated the survey instrument and methodology and which will provide a high confidence interval from the data. Once the data is gathered, the AIDS Institute has developed an Access-based software program with which to do the analysis.

Please note that this is not a part of the Needs Assessment, but a separate study recommended by HRSA as part of the continuing effort for Quality Improvement.

The first step will be to identify a service provider that is willing to volunteer a site at which to test the administration of the survey. Once the site is established, the sample size will be determined by the number of patients served.

QI Network Schedule-2008-2009

(Networks meet quarterly, however, due to service delivery model revisions some Networks meet monthly. Please refer to the HIV Planning Council Calendar for a current schedule.)

Medical Case Management QI Network

Mental Health/ Substance Abuse QI Network

Outreach QI Network

Medical QI Network

Oral Health QI Network

Pharmacy QI Network