Celebrating 14 years of leading innovations across the Ryan White community.


NQC e-Newsletter | Your expert guide to resources and technical assistance focusing on improving HIV care.


This month's issue focuses on the findings of the NQC Synergy report that was issued by NQC's external evaluator.  One finding that stands out is that the more technical assistance an organization receives from NQC, the better the organization performed on key measures.  This finding was consistent with the many Ryan White HIV/AIDS Program recipients that have sought services from NQC. 
Also, we recommend a short video in our Quality Tips.  This video has been used in other NQC trainings and is an easy-to-understand synopsis of the QI process.  A great video to show at your next QM Committee meeting!



Clemens Steinbock
Director, National Quality Center

> This Issue

In This Issue...
NQC Update | NQC Synergy Evaluation Report 
The National Quality Center (NQC) is committed to helping Ryan White HIV/AIDS Program (RWHAP) recipients and subrecipients provide the best possible care and services to people living with HIV. We are proud that the vast majority of RWHAP recipients/subrecipients have accessed these services.
Since 2004, NQC has provided technical assistance (TA), resources, tools and trainings to RWHAP recipients/subrecipients to establish and support effective and sustainable clinical quality management (CQM) programs for improving health outcomes among people living with HIV. NQC offers a variety of services including ongoing TA, short-term TA, Regional Groups, advanced QI trainings, collaboratives, and other initiatives, such as the in+care Campaign.To assess the impact of these activities, NQC collaborated with the JSI Research and Training Institute, Inc. to conduct a cross-activity evaluation to understand the overall impact of NQC service participation on organizational CQM program using the in+care Campaign performance indicators.
The Synergy Evaluation focused on a cohort of agencies funded by the HIV/AIDS Bureau (HAB) as of January 2014 that have participated in at least one NQC activity. The evaluation goals were to describe: 1) the overall NQC reach within the RWHAP and participating agencies' service utilization across NQC activities; 2) the synergistic impact of participation in different and multiple NQC components on organizational CQM capacity; and 3) impact on quality of care.
The findings are impressive. NQC has provided assistance to over 90% of the 587 RWHAP recipients funded in 2014. A total of 443 unique agencies (533 recipients) have participated in one or more NQC activity. NQC has reached 97% of Part D recipients, 94% of Part A, 92% of Part C, and 70% of Part B recipients. Recipients/subrecipients have engaged in various activities--in+care Campaign (64%), ongoing TA (60%), advanced QI training (59%), Regional Groups (48%), 27% collaboratives (27%), and short-term TA (15%). The average number of activities accessed by agencies was three (3) and the average time agencies had been engaged with NQC was 6.5 years.
Participation in NQC activities was associated with improvements in the quality of care. Across all agencies that participated in the in+care Campaign, performance scores improved on all four indicators between the first and last submission rounds.
  • The viral suppression measure improved overall between the first and last round across all agencies combined, and acrossall levels of NQC participation.
  • Performance scores for the gap measure significantly improved between the first and last round for ongoing TArecipients and for Regional Group participants. There were no statistically significant improvements for non-TA and non- Regional Group participants.The gap measure significantly improved for both advanced QI training participants and non- participants and for agencies that participated in 4 or more or 1-3 activities.
  • Performance scores for the medical visit frequency measure significantly increased between the first and last round across all agencies combined and all levels of NQC activity participation. The only exceptions were that there was no statistically significant improvement for non-TA participants and collaborative participants.
  • While performance scores for the newly enrolled patient retention measure increased between the first and last round for all agencies and across all levels of NQC participation; there were no statistically significant improvements.
NQC is using these results to inform future TA activities so we continue to meet the needs of RWHAP recipients/subrecipients and improve the quality of care for people living with HIV.
To access the report | Click here
Provider Profile | Magnolia Medical Clinic

With almost 10 years of experience as the program coordinator of the Ryan White Part C Program at Magnolia Medical Clinic in Greenwood, Mississippi and having completed both the NQC's Training of Quality Leaders (TQL) and Training of Trainers (TOT), Kawanis Collins was a good choice to serve as co-leader of Mississippi's team in NQC's HIV Cross-Part Care Continuum Collaborative (H4C). Magnolia, with a caseload of just over 200 patients, is one of the oldest HIV providers in the State. It is a one-stop shop providing medical care and case management, mental health, dental, and nutrition services and more. Supportive services are also provided, with transportation being a critical need in the mostly rural service area.
"Some of our patients live more than 45 minutes from the clinic," states Kawanis. "The transportation company's drivers often find themselves out on gravel roads when they are on their way to pick someone up."
While she has been leading quality-related activities at Magnolia for many years, Kawanis found that there was still much to learn from the H4C, mostly through the sharing of strategies across programs.
"Sometimes it is difficult to get to the goal that you are trying to achieve and you have a population of patients where it is difficult to bring about improvement," states Kawanis. "We saw that others were having the same struggles and we were able to exchange information and tools. When you think you have done everything possible, someone shares a strategy that just might work for you."
As part of H4C, Magnolia strengthened its communications with state workers, such as disease intervention specialists and case workers. This has led to more effective outreach activities targeting patients that have been lost to care. Magnolia is also addressing this challenge in a proactive manner through team huddles. The team identifies potential issues for patients that are struggling to remain in care. Providers go into appointments knowing these issues and can engage patients on how to address them.
While the H4C has had an impact at Magnolia, it has also strengthened ties between providers in the State.
"Our efforts are now more aligned as we work together to reach our State goals," states Kawanis. "It is not a competition. We are all working together to ensure the best care for our patients."

>March 2017 | Issue 105 | Vol 7

 Join the Leaders!  Take the QI Challenge and find out your QI IQ
> Upcoming  Events | March

>  TA Webinar  l  Lean Tools  l  March 30

National Quality Center

New York State Department of Health

AIDS Institute

90 Church Street, 13th floor

New York, NY 10007-2919

Phone | 212.417.4730

Fax | 212.417.4684



Improving HIV Care.

>   Quality Tip of the Month | Fundamentals of Quality Improvement
In the last few years, quality improvement (QI) has become a major priority in health care. This includes the Ryan White HIV/AIDS Programs - the legislation mandates clinical quality management. HRSA's HIV/AID Bureau Policy Clarification Notice 15-02 clarifies what is expected from RWHAP recipients and their subrecipients.
There is a wealth of training tools on how to carry out QI activities but there are fewer that explain the fundamentals of QI and its importance. This YouTube video is a quick (5 minute, 34 seconds) description of QI and its importance in health care. Take a look! It may be a useful training tool to share with your subrecipients. Understanding why QI is important is the first step towards embracing QI as a critical component in the provision of effective health care services that lead to improved patient outcomes.
To access the video | https://www.youtube.com/watch?v=nVF8IbjnSVE
NQC TA Webinar  |  Lean Tools

This month we will be discussing Lean tools and their use.  As you know, Lean is the hot topic in quality management.  A few months ago we discussed the basics of Lean, this month we will look at some of the tools used and discuss how they can be used in your programs.  The New York State Department of Health has made major investments in making government more Lean and many of these tools have been used with great success in DOH.  Please join us. 
Meeting information
Topic: Lean Tools
Date: Thursday, March 30, 2017
Time: 3:00 am, Eastern Daylight Time (New York, GMT-04:00)
Meeting Number: 643 868 018
Meeting Password: nqcwebinar123

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> About Us


We provide no-cost, state-of-the-art technical assistance to all Ryan White Program-funded grantees to improve the quality of HIV care nationwide.  


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This document is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U28HA041321200. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.