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This month we are pleased to profile two of our 2016 NQC Quality of Care Awards winners. Their work stood out and are outstanding examples of local quality improvement champions. Congratulations to this year's winners. Next month we will profile more NQC Quality of Care Award winners. In  the near future, they will be presenting on an NQC National TA Webinar to let others know about the exemplary work.
We are pleased to have provided many offerings at the recent 2016 Ryan White Conference on HIV Care and Treatment. Take a look at our recap in this issue.   


Clemens Steinbock
Director, National Quality Center

> This Issue

In This Issue...

> Quality Award Profile | 2016 Award for Measurable Improvements in HIV Care: Nationwide Childrens' Hospital; FACES Quality Improvement Committee
The Family AIDS Clinic and Education Services (FACES) program at Nationwide Children's Hospital is central Ohio's primary HIV clinic, serving more than 400 HIV-infected clients in more than 40 counties. The program's quality improvement committee (QIC) was recognized for their successful implementation of a "stoplight project" focused on increasing viral suppression. The project aimed to get as many clients as possible to an undetectable viral load (≤ 40) level. This target is much lower than the 200 copy/ml threshold required for HRSA reporting.
The QIC meets twice a month to review viral load data for each client, particularly those for clients in the "red light" category (load >1000 copies/ml) and clients with a viral load showing evidence of a loss of virologic control. Each client is discussed and individualized multidisciplinary care plans are developed.
Through a review of the patient population, the QIC identified three key drivers that prevented achievement of viral suppression-mental illness, non-compliance with medications, and failure to show up for appointments. Interventions were developed in response to each driver. For example, the interventions related to no shows included reminder calls to patients 48 hours prior to an appointment to make sure the client can arrange transportation with their insurance company and calls by peer navigators within 24-48 hours of a missed appointment.
Since the project was initiated in 2013, the viral suppression rates have increased significantly. In 2013, 68 percent of clients were suppressed. By 2015, 80 percent of clients were suppressed. Congratulations to the 2016 NQC Award for Measurable Improvements in HIV Care.

> Quality Award Profile | 2016 Award for Measurable Improvements in HIV Care: Family First Health: Caring Together Program
Family First Health is a community health center with five sites serving approximately 28,000 clients in South Central Pennsylvania. The Caring Together Program has been receiving RWHAP Part B and C funding since 1991 and serves approximately 550 clients.
In July 2014, Caring Together embarked on a 2-year quality improvement project focused on retention. Using the in+care Campaign's definition of medical visit frequency, in August 2014, data indicated a retention rate of 64 percent. Over a 2-year period, the program had seen a drop in medical visit frequency of 8.6 percent. The clinical quality management committee focused on using data to explore disparities and identify barriers to care. Several issues were found, including a glitch in CAREWare, process problems, and a disparity in the data for clients falling under 100 percent of poverty. After the CAREWare issue was resolved, the rate increased to 70 percent.
In response to the findings, processes were revised. The processes for refilling medications and completing lab work were streamlined and the process for reviewing out-of-care clients was improved. The CDC's Anti-Retroviral Treatment and Access to Services (ARTAS) intervention was also implemented. ARTAS is an individual-level, multi-session, time-limited intervention with the goal of linking recently diagnosed persons with HIV to medical care soon after receiving their positive test result.
As of January 2016, medical frequency measure is at 77 percent-an increase of over 12 percent from baseline data. Over the study period, viral load suppression rates also increased from 84 percent to 88 percent. Congratulations to the 2016 NQC Award for Measurable Improvements in HIV Care.

NQC Update | TCQPlus - How to build the local capacity for consumer involvement in quality improvement?
NQC held its first Training of Consumers on Quality (TQC) Plus, June 21-23 in Atlanta, GA.  Eleven 
teams attended, which were made up of at least one consumer and a representative from RWHAP-supported providers. NQC developed the TCQPlus Program in recognition of the demand for local Training of Consumers on Quality (TQC) training opportunities and the realization that another level of training was necessary to address the desire of RWHAP recipients to involve consumers in their clinical quality management programs. A central aim of TCQPlus is to strengthen the training capacity among consumers and RWHAP recipients to conduct local quality improvement trainings for consumers. [EC1] 
To ensure the necessary commitment and the successful implementation of TCQ trainings, NQC designed the TCQPlus Program around the concept 
of "training partners." Training partners consist of a qualified consumer who is engaged with a RWHAP recipient(s) and a representative from a RWHAP recipient. Both the consumer and the representative attend the training. Following the training, they work together to conduct consumer trainings in their local jurisdiction.
An example of this partnership is the team from the Middlesex-Somerset-Hunterdon TGA (New Jersey). Three consumers-Christine Lackey, J. Gavin, and Ricardo Salcido-attended the first TCQPlus session along with their "partner" Terri Fox, a research analyst at the Institute for Families at Rutgers University School of Social Work. Christine, J., and Ricardo are all members of the TGA's Consumer Quality Workgroup. The team has already held a training that was attended by eight consumers and is planning a second training.
To learn more about the TCQPlus | NationalQualityCenter.org/TCQPlus

> Sept. 2016 | Issue 99 | Vol 7

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

TA Webinar  l   Lean and You

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.

> NQC Update | Reflections from 2016 National Ryan White Conference on HIV Care and Treatment
Thanks to everyone who joined NQC at the National Ryan White Conference on HIV Care and Treatment last month in Washington, DC. NQC held six workshops on a wide range of quality improvement topics and two networking events-one for Regional Group members and one for the HIV Care Continuum Cross-Part (H4C) Collaborative-where participants could share their experiences with their peers. NQC was pleased to co-present with many recipients during the conference. Over 400 individuals attended our workshops and networking sessions.
NQC's booth in the exhibit hall provided us the opportunity to meet with many recipients face-to-face and distribute NQC materials. Over the 4 days we distributed over 2,000 resources. As always recipients were enthusiastic about quality and interested in NQC's myriad programs.
To download all slide sets that were presented during the conference | Click here
To review all pictures taken by NQC | Click here
> Quality Question of the Month: | Do You Actively Engage Consumers in your Local Improvement Efforts? 
Starting this month we will feature a "Quality Question of the Month" that RWHAP recipients should consider as they carry out their clinical quality management programs.The titles of the documents are hyperlinks so you can access them simply by clicking on the title.  
RWHAP recipients are required to include consumers in their quality improvement efforts. NQC has a number of resources designed to help recipients do this-from many tools available on the NQC website to our TCQPlus Program.  
The guide provides suggestions for the successful involvement of PLWH as partners including implementation ideas for proven and effective methods of promoting and enhancing PLWH involvement. It also describes the benefits to quality of care that come from optimizing consumer input. It is designed for both clinical and non-clinical staff.

Because of the demand for consumer training throughout the RWHAP community, NQC has developed a training guide and slide set that will assist recipients in conducting trainings similar to the TCQ. NQC can also provide guidance on how best to present the information to participants.

This survey was developed by the New York State Department of Health AIDS Institute to give HIV providers an HIV-specific, validated tool to assess consumer satisfaction with HIV primary care. The survey provides a quantitative opportunity to capture the "voice" of consumers and is a useful source of information for clinical quality management programs.

Most of you have visited the Quality Academy at some pint.  Back in April we announced a new tutorial on consumer self-management.  This will be the first of a set of tutorials which ar4 focused on helping consumers take on meaningful rolls in a provider's quality management program. 

> National TA Webinar | Lean and You

This is an introduction to the Lean method of quality improvement and some useful tools. This methodology is perfectly suited to increasing efficiency in the delivery of care, satisfaction in the receipt of care, engagement of the workforce giving care, and quality in the outcomes of care. 
Upon completion of this TA Call, participants will be able to:
  • Describe Lean methodology, history, and basic tenants
  • Introduce basic Lean tools
  • Identify improvement projects conducive to using Lean methodology
  • List key factors for successful project implementation
  • Describe key conditions for organizational implementation
Meeting information 
Topic: Lean and You 
Date: Thursday, September 15, 2016 
Time: 3:00 pm, Eastern Daylight Time (New York, GMT-04:00) 
Meeting Number: 641 071 261 
Meeting Password: nqctacall123 

To start or join the online meeting 
Go to:

Audio conference information 
1. Provide your number when you join the meeting to receive a call back. Alternatively, you can call one of the following numbers: 
Local: 1-518-549-0500, Toll Free: 1-844-633-8697,  1-866-776-3553 
2. Follow the instructions that you hear on the phone. 
Cisco Unified MeetingPlace meeting ID: 641 071 261 

To add this meeting to your calendar program (for example Microsoft Outlook), click this link: 

NQC Offering | New Job Forum 

Send us your quality-related job postings!  We would be happy to share them in our newsletter. 
> 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.  


Send questions, comments, or suggestions | Info@NationalQualityCenter.org   


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.