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




With the holiday season just behind us, the National Quality Center is looking forward to assisting Ryan White grantees achieve their quality improvement goals in 2013. We are especially excited to work with newly funded Part C and D grantees accross the country in the coming months!


NQC is starting off the new year with a set of newly enhanced offerings!  Glasscubes will replace ProjectSpace to make all of your centralized communications easier. The enhanced in+care data report is also now available for your use. You can compare your clinic with our national data set and see what you can do to improve your quality performance.


As always, please feel free to contact NQC for assistance in building or refining your quality management program.


Warm regards,


Clemens Steinbock

Director, National Quality Center


> In This Issue

> NQC News | in+care Update: The Enhanced Data Report is Here!
> HIVQUAL Update | HIVQUAL-US and ABMS at the IHI National Forum
> NQC Resource | Glasscubes Replaces ProjectSpace
> Real World Quality: Paul Cassidy
> Consumer Perspective | Toby Austin
> NQC Consultant Spotlight: Hollie Malamud-Price, MPH
> Highlights from the NQC Collection | Choosing the Right Improvement Project

> NQC News | in+care Update: The Enhanced Data Report is Here!


The much anticipated in+care Campaign Enhanced Reports are here. The first version of these reports examines data submitted by participants in two ways: 1) Ryan White (RW) Part by Measure; and 2) Measure by RW Part. The data on each page are represented in three views - a table, a run chart and a spark line distribution spread.

The data table shows how each RW Part performed for each of the four measures across the six most recent reporting periods. In addition to direct grantees of the four RW Parts included in the Campaign (A, B, C and D), the table includes a total that rolls up the direct grantee data in addition to data submitted by sub-grantees. Data presented in the table include the community average performance, expressed as a percentage in addition to the number of sites reporting and the number of patients represented in the sample.

The run chart tracks performance over time for each of the RW Parts for each measure. Over time, additional observations will be added for each reporting period tracking the full history of Campaign participant performance. The chart is marked with arrows indicating whether a higher or lower score is a 'good' score (remember that the Gap Measure shows stronger performance in lower percentage scores whereas the Visit Frequency, New Patient, and Viral Suppression Measures show stronger performance in higher percentage scores).

Spark lines were created by Edward Tufte as a novel way to display data.  Sparklines are word-sized graphics used to illustrate data. NQC uses spreadgraphs, a type of sparkline that displays the distribution of clinic-level scores. Each clinic is represented by an individual tick mark. The mean score is highlighted in red, and the 25th and 75th percentiles are highlighted in blue.

Learn more about spreadgraphs  |  http://www.edwardtufte.com/bboard/q-and-a-fetch-msg?msg_id=0001OR

As with any data report, this one is not without its limitations. All data are aggregate data points, self-reported by HIV provider sites participating in the in+care Campaign. Participants have opportunities to describe their individual limitations for each observation entered into the in+care Campaign database. Data collection methods vary by participating site and RW Part funded. Some site data could be counted multiple times if they were submitted individually by the participating site in addition to a networking lead agency and if the site is part of a network of providers (i.e., a Part A of Part B sub-grantee). Patient counts are not unduplicated. A patient may be counted more than once in the denominator if s/he received care at multiple sites. Data collection may be incomplete due to individual clinics' limitations. Finally, some participating sites submit data for a sample of patients.

Visit www.incarecampaign.org to see the reports (click Resources tab and look in the Enhanced Campaign Reports folder).

Questions about these data reports | Email Michael Hager - Michael@NationalQualityCenter.org

> HIVQUAL Update  |  HIVQUAL-US and ABMS at the IHI National Forum 


HIVQUAL is an approved portfolio sponsor in the American Board of Medical Specialties (ABMS) Multi-Specialty Maintenance of Certification (MOC) Program. Through the ABMS MOC Program, physicians engaged in quality improvement through HIVQUAL are eligible to earn Part IV MOC credit for their quality improvement activities. 

HIVQUAL, accompanied by eight other ABMS Portfolio Sponsors, participated in a Learning Lab at the Institute for Healthcare Improvement (IHI) annual Forum in December 2012. The purpose of the Leaning Lab was to explore the process of applying to and participating in the Multi-Specialty Maintenance of Certification (MOC) Program. The interactive Learning Lab?, 'The Role of Multi-Specialty MOC in Physician Quality Improvement Involvement,' offered participants an opportunity to learn more about each portfolio sponsor, including organizational structures to support participation and implementation, planning and engagement, the role of physician leadership in quality improvement and recommendations for future applicants as the Program expands to new medical specialties and portfolio sponsors.

To learn more | http://www.hivqualus.org/index.php?q=hq-us-and-american-board-medical-specialties-program

> NQC Resource | Glasscubes Replaces ProjectSpace


Those of you that have used ProjectSpace know that it was a convenient way for a group of individuals to maintain a group workspace and a calendar. NQC was notified that ProjectSpace would be discontinued on December 31, 2012.  A search was undertaken and NQC found Glasscubes as a replacement for ProjectSpace.  The feedback we have received so far confirms why we chose Glasscubes in the first place - it as an easy-to-use interface, has the same features as ProjectSpace and is visually appealing.

All of the ProjectSpace administrators have been contacted and invited to join Glasscubes. If you have not been invited to a new Glasscubes group as of yet, please contact the site administrator with whom you previously communicated.  ProjectSpace also sent NQC an archive file containing the latest version of all documents in ProjectSpace; it's organized by site name and then by folder so no information is lost.

If you have questions about Glasscubes or would like a workspace set up fo ryou | Contact Kevin Garrett at Kevin@nationalqualitycenter.org 

> Real World Quality: Paul Cassidy

Peer learning has always been an emphasis of NQC's approach and Paul Cassidy is a proponent. "Sharing ideas and tools makes it easier for us all," says Paul.

As Coordinator of the Infectious Disease Program at Greater New Bedford Community Health Center (GNBCHC) in Massachusetts, Paul oversees the Ryan White Part C- and D-funded activities that serve over 300 consumers. Since coordinating quality-related activities is part of his responsibility, Paul has accessed NQC services for years-he attended the first Training of Trainers workshop.

Paul has worked with NQC consultant Nanette Brey Magnani on various aspects of the GNBCHC's quality management program. For example, Nanette conducted a process diagram exercise with staff, which resulted in nurses raising a concern about scheduling.  In response to the discussion held during the exercise, appointments were lengthened so that nurses could discuss adherence with patients.

Nanette has also helped Paul connect with other Part C grantees through the Statewide Quality Management Group. Nanette convenes the members and sets the agenda so members can focus on the topic and not administration.  "Over the years I have had opportunities to meet with peers but in this group we exchange ideas about quality management within our programs," says Paul. "The group allows me to meet with colleagues with similar responsibilities and discuss approaches to quality."

Taking his networking a step further, Paul participated in two NQC-coordinated workshops during the Ryan White Grantee Meeting this past November.  The workshops addressed the development of workflow process diagrams.

"Participants took away something that is doable and relates back to quality and quality improvement," says Paul.  "I articulated what we do in my own program and challenged participants about their own programs."

And, it is not just at meetings that Paul exchanges ideas with his peers. "I look to the NQC website for resources and have also posted tools from my own program."  Way to go Paul!

> NQC e-Newsletter | Vol. 5 | Issue 55 | January 2013 

Quick Links


> Upcoming Events | January - February

January 9 | in+care Campaign Webinar | Sustaining Retention Projects in Unsure Funding   Environments

January 10 | in+care Campaign Webinar | Mental Health and Retention

January 17 | National TA Call | Moving Beyond Data - Choosing the Right Improvement Project

January 30 | Journal Club Webinar | How Can We Increase Initiation of and Retention in Care Among Persons Living with HIV

February 21 | National TA Call | The Right Tool for the Job - Using QI Tools in Your QI Work

> Consumer Perspective: Toby Austin

Life in a rural area can bring an element of isolation, especially for a person living with HIV/AIDS. Toby Austin knows this first hand.  While he lives in West Virginia, he was accessing services in Virginia because they better fit his needs. In particular, it was the support groups that were most important to Toby, and it was through a support group that he came into contact with NQC. Another member of the group emphasized the importance on consumer advocacy and introduced Toby to NQC's offerings.

"Not only has my participation with NQC led me to take an active interest in my own health care, it has led me to take an interest in the services available to my community as well," says Toby. "In my initial contacts with NQC, the emphasis was on better self care. You have to take care of yourself if you are going to be an effective advocate."

Through NQC, Toby has attended four learning sessions and NQC's Training of Consumers for Quality workshop, which was held in spring, 2012. "NQC really changed how I think about care," relates Toby. "It was almost like an epiphany. All of the sudden I understood the role of others in my care and my own role."

Since his epiphany, Toby has become an extremely active advocate for himself and other consumers. In December, he was sworn in as a member of the Ryan White DC EMA Planning Council (representing two counties in West Virginia). He is planning to advocate for a more active role for consumers with providers in West Virginia, including the formation of a consumer advisory board. In addition, Toby was a speaker at a local observation for World AIDS Day 2012.

"I never imagined that I would be able to speak in a public forum about my HIV," says Toby. "NQC gave me the tools and training I need to put a face on AIDS."

> NQC Consultant Spotlight: Hollie Malamud-Price, MPH

In addition to our staff, the NQC has a team of highly qualified consultants that are available to work with Ryan White grantees to address quality-related issues. When you confront challenges, think of our consultants and what they can offer. In many cases, project officers are first to suggest their services. Below we profile one of the many consultants available to Ryan White grantees.

Hollie joined the NQC in May 2012 and brings 18 years' experience in public health, including: quality management; program management; program development; policy development; training; and facilitation.  Her career has focused on maternal/child health and HIV/AIDS.  At the Michigan Department of Public Health, Hollie spent six years as the Ryan White Part D Program Coordinator. While there, she established the Part D Quality Management Program, as well as a Cross-Parts Quality Management Program for the State, which aligned quality indicators across Ryan White Parts A-D.  As a coach, she brings the understanding from the grantee perspective of the challenges Ryan White programs may face in implementing and sustaining a quality management program.  Hollie also understands the tremendous value of a coach, as she was a recipient of coaching as a grantee.

Hollie received her Master's in Public Health in Population Planning from the University of Michigan.  Over the years, she has presented at over 20 national, State, and local conferences, and on national educational conference calls. A native Detroiter and Mid-Westerner, Hollie moved to Philadelphia four years ago.  She is currently leading the Philadelphia Regional Group, providing coaching to the Philadelphia grantees, and is the designated coach for the Philadelphia in+care Campaign participants.  She is looking forward to her continued work as a coach, as she is passionate about quality management; and the impact it has on both the health care providers delivery of care and on the services clients receive.

> Highlights from the NQC Collection  Moving Beyond Data: Choosing the Right Improvement Project

Many people see data collection as a way of documenting efforts but it can also be used to improve performance. NQC has many resources designed to foster the link between performance measurement and quality improvement activities. They focus on how to take action based on data performance findings.

National TA Conference Call: January 17
3:00 - 4:30 pm ET

Our call this month will focus on how to choose an improvement that will have impact in you Ryan White Program.  Many grantees have rich sets of data at their disposal but struggle with setting improvement priorities.  Our main presenter this month will be Dr. Kathleen Clanon along with selected grantees that have experience in this topic. 

Learning Objectives:
* Understand what you data is telling you
* How to set priorities for your quality improvement work
* Choosing the project that will have the most impact

To Register  |  Click Here

As part of our newly expanded National TA calls, NQC is now suggesting that grantees review these resources before the call: This will help you to frame questions for our presenters and enhance your learning experience.

Prework Resources
1. Past TA Calls
Finding the Link: Using Data Reports to Initiate QI Projects, June 2011

2. Quality Academy Tutorial: Narrowing Your Focus - Using Data to Launch Improvement Activities

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

Email | Info@NationalQualityCenter.org 


Sharing, Training, Consulting.

Improving HIV Care.

> 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 e-Newsletter is produced by the National Quality Center, a quality improvement initiative funded through a cooperative agreement with the Health Resources and Services Administration (HRSA) HIV/AIDS Bureau. For more information | NationalQualityCenter.org  


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