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.


NQC is gratified at the turn out for the end + disparities Learning Exchange kick off webinar on October 20. We had over 300 individuals participate in this launch.  The Health Resources and Services Administration HIV/AIDS Bureau and the National Quality Center (NQC) have teamed up to launch the end+disparities Learning Exchange, which seeks to reduce HIV-related health disparities as discussed in the National HIV/AIDS Strategy (NHAS): Updated to 2020.

The Learning Exchange is a 9-month initiative that promotes the application of quality improvement interventions with the ultimate goal of increasing viral suppression rates for disproportionately affected HIV subpopulations.
We are also pleased to bring you a profile of the St. Louis Part A program, a good example of how perseverance pays off.  St. Louis has worked hard over the past few years on their quality program and in spite of staff turn over they have made impressive strides.  Take a look at what the St. Louis Part A program has done in our profile article.


Clemens Steinbock
Director, National Quality Center

> This Issue

In This Issue...
NQC Offering | end+disparities Learning Exchange: Available Resources
Last month, HAB and NQC launched theend+disparities Learning Exchange, which seeks to reduce HIV-related health disparities. This 9-month initiative promotes the application of quality improvement (QI) interventions with the ultimate goal of increasing viral suppression rates for four disproportionately affected HIV subpopulations:
  • MSM of color;
  • African American and Latina women;
  • Transgender people; and
  • Youth.
NQC has highlighted resources in support of this initiative:
NQC Disparities Calculator and Guide: The Disparities Calculator was developed by New Solutions, Inc. and adapted by NQC for the purpose of the Learning Exchange. The Disparity Guide was developed to help users learn how to use the Disparities Calculator and the underlying statistical models. We have five PowerPoint presentations available to help users understand the statistics behind the Disparities Calculator and how to present the information to others.   Click here to review the NQC Disparities Calculator and supporting materials.
Literature Review Findings : A compilation of research related to HIV-related health disparities is available in a literature review write up, as well as a PowerPoint presentation to highlight key findings. Click here to review the end+disparities Learning Exchange Literature Review Findings.
ShareLab : Participants in the Learning Exchange will share their QI activities and what they have learned from them via our online platform, called NQC ShareLab. Click here to visit NQC ShareLab.
In addition to these and other resources, NQC will be holding monthly webinars as part of the Learning Exchange.
Learn more about theend+disparities Learning Exchange |

>   NQC Update | HIV Cross-Part Care Continuum Collaborative (H4C)
H4C, a 24-month collaborative involving five states (Arkansas, Missouri, Mississippi, New Jersey, and Ohio), transitioned to its sustaining phase in January 2016, but participants are still actively engaged in the work. The goals of the collaborative included building regional capacity to close gaps across the HIV Care Continuum, aligning clinical quality management goals across Ryan White HIV/AIDS Program ( RWHAP) Parts with jurisdictional goals in each state, and implementation of joint quality management activities within and across states. By the end of the 24-month collaborative, there were 55 RWHAP recipients caring for nearly 44,000 patients across the five states were submitting performance measurement data and contributing to statewide quality improvement projects.
Over the course of the initiative, performance in ARV prescription and HIV viral suppression improved (4.5% and 1.4% respectively). Performance in retention measures stagnated due to a number of reasons, including the overarching focus on HIV viral suppression and the fact that consumers in long-term stable care are resistant to being seen every six months. An HIV viral non-suppression cohort was established to see how far states could go in bringing all people with HIV in their states into viral suppression. During the course of the collaborative the goal to suppress 20% of those initially unsuppressed was met (unadjusted). Overall, the initiative was one of the most successful collaboratives run by NQC and HAB. It had the greatest number of continuous participants, the greatest level of improvement interventions shared, and the greatest level of improvement ever seen in a single measure (HIV non-suppression cohort). NQC is excited to plan and deliver additional cross-part collaboratives in the future.
To learn more about this initiative | http://nationalqualitycenter.org/nqc-activities/collaboratives/h4c-collaborative/
Provider Profile | St. Louis TGA
The implementation of the Affordable Care Act (ACA) over the past few years has brought about many changes for Ryan White HIV/AIDS Program (RWHAP) recipients, including the St. Louis Part A TGA. The TGA currently serves approximately 3,000 clients. About 45 percent are seen by private physicians on a fee-for-service basis. These physicians typically have caseloads from 30-300 RWHAP-supported patients.
The shift to fee-for-service impacted both data collection and quality improvement (QI) activities in the TGA. These physicians and their staffs lack both the time and the expertise to engage in required data reporting (i.e., core HAB performance measures) and QI activities. In addition, finding a convenient time to bring these providers together for QI activities was a challenge.
"We decided that if they cannot come to us we would go to them," says Katie Wolf, the Ryan White Regional Education Coordinator for the TGA. "We had success co-locating case managers with some providers and decided to build on it."
Beginning in March 2015, the TGA began planning QI processes using data received by co-locating case managers with the private physicians. In addition to their case management duties, they were charged with compiling the necessary client-level data to track core performance measures. If they found missing data, it triggered follow up-either to obtain the missing data or to track down clients that had fallen out of care.
"Co-located case managers have allowed us to get more accurate data on a greater number of clients," says Katie. "They drill down at the client level while we work to fill the holes in our data collection system."
There was not a systematic approach for training case managers since they had already been co-located at the largest AIDS service provider in the TGA. Instead, the process was individualized and case managers were provided the support they needed given their provider assignments.
At the same time they were co-locating case managers, the TGA reinvigorated its quality management committee. Given that the physicians and their staff did not have the time (and were not reimbursed) to attend these meetings, the RWHAP case managers were assigned this responsibility. Many took what they learned back to the providers and implemented QI projects.
In April 2016, NQC's Michael Hager conducted a Quality 101 training for recipients in the TGA. He also conducted a state-wide training for case managers. The training focused on the importance of the performance measures and the basics of quality improvement. According to Katie, case managers left the training with a greater understanding of the importance of collecting client-level data for performance measurement and were more motivated to engage in QI projects with the fee-for-service providers.
"The NQC training not only helped me import the tools necessary to champion QI processes in the region, but challenged me to look honestly at our unique structure of service delivery," says Katie.

> Nov. 2016 | Issue 101 | Vol 7

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

NOVEMBER 4 - Office Hours: Strategic Planning and Disparities in QI.   1-2pm ET
NOVEMBER 17 - Baseline Data Webinar and Partners in+care Launch.   1-3pm ET
NOVEMBER 18 - Office Hours: Helping Consumers Understand Baseline Data.  1-2pm ET

Dec. 1  l  TA Webinar   l   Evaluating your quality improvement projects Part II

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.

> National TA Webinar Evaluating your QI Projects: Part II

This month, NQC is pleased to offer part II of our well-attended webinar "Evaluating your Clinical Quality Management Program and Improvement Efforts."  This month we will do a deeper dive into evaluating your clinical quality management program, utilizing case studies and a QI tool to examine QI projects and how all this applies to the various RWHAP Parts.
Our learning objectives are:
  • Review the key elements of evaluating your CQM program
  • Examine the specific areas of focus for evaluating QI projects
  • Utilize case studies and a QI project evaluation tool to examine QI projects
  • Explore the differences in approach between evaluating agency and systems-level QI projects
Please note the time/date change
To join the webinar:
Meeting information
Topic: Evaluating your QI Projects: Part II
Date: Thursday, December 1, 2016
Time: 3:00 pm, Eastern Standard Time (New York, GMT-05:00)
Meeting Number: 647 637 443
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, or  Toll Free: 1-844-633-8697; Alternate Toll Free - 1-866-776-3553
2. Follow the instructions that you hear on the phone. Cisco Unified MeetingPlace meeting ID: 647 637 443
To add this meeting to your calendar program
Quality Question of the Month | Do you use the resources that are available to you?
As NQC has worked with Ryan White HIV/AIDS Program (RWHAP) recipients over the years we have always stressed the importance of not reinventing the wheel. NQC has many resources designed to give you a head start in your quality-related activities. Some are based on the experiences and lessons learned of RWHAP recipients. Others have been developed by NQC staff, consultants, and subject matter experts. The end+disparities Learning Exchange initiative makes still more resources available (see above).
While it can be tempting to jump right into a project, take the time to check out NQC's resources before you begin. Using these resources can save you a lot of time in the long run!
To help you organize your written quality management plan
To help you evaluate your clinical quality management program
Learn how to prioritize your improvement priorities
Understand the message ion the numbers; a helpful guide to seeing where you need to improve
A unique resource that offers hundreds of examples of QI projects undertaken by your peers
> 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.