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




This month NQC is pleased to announce the release of HIVQUAL Brief 10, Improving Cervical Cancer Screening in California and Chicago. HIVQUAL Briefs provide valuable information on improvement projects undertaken by your peers and provide guidance on conducting your own projects. Please take a few minutes to review the current issue and browse the past issues.


NQC is also excited to announce that Training-of-Trainers and Training of Quality Leaders Program sessions will be held in the first half of 2014. Next month we open the application process to give grantees time to make travel arrangement and obtain travel approvals. We are looking forward to once again proving these valuable training opportunities to you and hope you take advantage of them.




Clemens Steinbock

Director, National Quality Center


> In This Issue

> NQC News | H4C Vanguard Meeting
> NQC News | HIVQUAL Brief: Improving Cervical Cancer Screening
> NQC News | in+care Campaign Update
NQC Training Update | TOT and TQL in 2014
> Quality Corner: Regional Groups Promote Collaboration
> Quality Tip of the Month | Evaluating the Client Experience
> National TA Call | Making Clients Feel Welcome

> NQC News | H4C Vanguard Meeting


The HIV Cross-Part Care Continuum Collaborative (H4C) seeks to improve cross-Part collaboration within specific states, with a focus on viral load supression, as called for in the President's Executive Order on the Care Continuum Initiative. Seven states were identified to participate in the Collaborative: Arkansas, Indiana, Maryland, Mississippi, Missouri, New Jersey, and Ohio.


In September, NQC convened the Vanguard Meeting for H4C. Twenty-two (22) participants representing the various Parts from all seven states attended to engage the HIV provider networks and agencies across their state to participate.


Over the next 18 months, the cross-Part teams will work to improve identified gaps in retention and viral suppression. Face-to-face learning sessions will be held to share progress and lessons learned across teams. By the end of the 18-month period, states participating in H4C will be able to produce routine and reliable HIV care continuum data for use in state-wide and cross-Part quality management. In addition, each state team will complete at least one state-wide quality management project involving all the Ryan White providers in the state related to the HIV care continuum.


For more information on H4C, including the white paper and the presentations from the Vanguard meeting | http://nationalqualitycenter.org/index.cfm/17112/84058


Information is also available via email from Michael Hager | Michael@NationalQualityCenter.org

> NQC News | HIVQUAL Brief: Improving Cervical Cancer Screening


The latest issue of HIVQUAL Briefs (Vol. II, Issue 2) is now available. This edition highlights recent quality improvement projects by the Santa Rosa Community Health Center and the Chicago Department of Public Health HIV Primary Care Program to increase rates of cervical cancer screenings among HIV-infected patients. By identifying their benchmark screening rate, setting manageable goals, and designing useful interventions, both programs were able to significantly improve their screening rates.


View current and past HIVQUAL Briefs | http://nationalqualitycenter.org/index.cfm/5847/84446


Comments or questions regarding the HIVQUAL Briefs may be sent to Jonathan Peters at jbp02@health.state.ny.us.

 > NQC News | in+care Campaign Update


In November, the in+care Campaign is focusing on the health of transgender individuals-a highly vulnerable and disenfranchised population. Presentations will focus on barriers and facilitators to engagement in HIV care for transgendered individuals and also will provide key strategies that have been effective at maintaining engagement in care over time. If you have any insight on retention strategies that work for transgendered individuals, please submit your lessons learned to Campaign staff | www.incarecampaign.net/index.cfm/78891


The in+care Campaign is currently finalizing the newest set of Enhanced Reports! Stay tuned to the in+care Campaign website to catch the new reports when are posted. In addition to the reports that have already been produced, we are finalizing a report that examines the types of improvement strategies that have been implemented by Campaign participants over the last two years.


While the in+care Campaign is moving into a sustaining phase with less frequent activities, the Campaign is not ending. The website and database will continue to be maintained for the foreseeable future. The learning and updates for the in+care Campaign will be incorporated into NQC announcements, newsletters, and TA calls beyond January 2014.


Upcoming Events and Deadlines

November 12, 2:00 pm ET | in+care Campaign Journal Club | Retention in Care and Health

Outcomes of Transgender Persons Living with HIV


Transgender individuals are nearly universally seen as being a highly vulnerable group, with regards to both illness and health care. A recent study, however, shows that disparities in HIV care for transgender individuals with access to care in comparison to non-transgender individuals are narrowing. During the webinar, Dr. Yehia will share the results of this study with the in+care Campaign community. In addition, he'll describe how the findings of the study are directly applicable to the ongoing retention work at clinics and health departments across the U.S. The presentation will be followed by a question and answer period with the study author.

Please note that no prior registration is needed to participate in this webinar. Just click the webinar link to join and enter the room as a guest. Type your name when prompted to enter the webinar room. If you have any questions, comments or concerns you would like addressed during the presentation, please send them to Michael Hager in advance (Michael@NationalQualityCenter.org).


Dial-in Number: 866.394.2346

Participant Code: 397 154 6368 #

Webinar URL: http://www.nqcqualityacademy.org/incarecampaign


> NQC e-Newsletter | Volume 7 | Issue 65 | Nov 2013 


Quick Links


> Upcoming Events | November - December


November 2 - 6 | American Public Health Association Annual Meeting


November 12 | in+care webinar | Retaining Transgender Individuals In Care


November 15 | Improvement Update Submission Deadline


December 2 | Campaign Data Submission Deadline

> NQC Training Update | TOT and TQL in 2014


Save the Date! NQC is pleased to announce that a Training-of-Trainers (TOT) session will take place in Indianapolis, IN on March 11-13, 2014 and a Training of Quality Leaders (TQL) will take place on May 6-8, 2014 in Kansas City, MO. The application process will open in November and a special announcement will be sent which will have the link to apply and the hotel information.


Training-of-Trainers (TOT) Program

The TOT Program is designed to build capacity for quality improvement among quality managers. It is designed for individuals with a strong experiential background in quality management. Since the purpose of the TOT Program is capacity building, participants are asked to lead at least three trainings within 120 days of completing the session. The goals of the TOT program include:

  • Enlarge the pool of qualified trainers on quality improvement in HIV care across the country
  • Further spread quality management concepts by increasing the number of training opportunities for Ryan White grantees
  • Increase the ability of NQC to refer requests for QI training to regional TOT trainers
  • Build capacity in Ryan White-funded programs on quality improvement


Learn more about the TOT and/or to apply | nationalqualitycenter.org/index.cfm/17290


Training of Quality Leaders (TQL) Program

The TQL Program aims to build the capacity of quality managers and those who direct quality management programs to effectively lead and facilitate quality improvement activities. It provides participants the ability to enhance their own expertise in quality management and support team dynamics. The goals of the TQL program include:

  • Increase confidence and mastery in facilitating quality improvement teams and in effectively managing quality improvement-related meetings in HIV care environments
  • Identification of leadership behaviors to lead an effective QM program and better understand their implications to lead quality improvement activities
  • Exposure to quality improvement experts with practical knowledge and experience and to a network of peers with hands-on experiences

Learn more about and/or apply to the TQL | nationalqualitycenter.org/index.cfm/5847/19644

> Quality Corner: Regional Groups Promote Collaboration


Collaboration takes many forms within the Ryan White community-agencies work together at the local, state, and regional level. NQC helps foster collaboration through support of regional groups.  The groups are designed to build the capacity of Ryan White agencies to implement comprehensive quality management programs in their facilities. Groups identify their own priorities, promote peer learning, and exchange best practices-all under the guidance of an NQC coach. There are 23 regional groups across 24 states and Puerto Rico.

In North Carolina, all the Ryan White grantees in the state have been working together on quality improvement activities for the last four years.  The regional group was convened by the Part B grantee, the North Carolina Department of Health. Since 2011, the regional group has been working with NQC coach, Lori DeLorenzo.  Most recently, activities have focused on viral load suppression. Members submit their data every three months-and then they explore the results.

"It's a forum where agencies can regularly get together to talk about their data and the strategies they are implementing," says Lori. "They can exchange information that is constructive in a safe environment."

The sharing takes many forms.  At a recent meeting, "lightning rounds" were conducted.  Each agency presented a single PowerPoint slide that told the story of their viral load data and related improvement efforts. This type of exercise gives everyone at the meeting a chance to present their work-not just top performers. It also allows a lot of information to be presented in a very short period of time.

"It gives every agency an opportunity to shine," says Lori. "Before, some people just came to the meetings and observed. With this type of presentation, we hear from people who might have never engaged in discussions."

One of the many benefits of such discussions is that participants can learn about tools that other agencies are using. For example, there has been much discussion among participants about the use of dashboards-relatively easy to implement tools that can facilitate the presentation (or visualization) of data and tracking of performance measures.

Besides the quarterly meetings, participants take advantage of the group's Glasscubes virtual office space.  This online forum, supported by the NQC, allows participants to share and discuss materials. In addition to materials and tools, Lori and the participants post articles and other resources that can be useful.

While viral load suppression has been the focus in recent months, the group provides an opportunity to share information on other issues. Ryan White agencies in North Carolina are participating in the SPNS Linkage to Care Initiative. Through the Regional Group forum, participants in the SPNS initiative have passed their retention and re-engagement strategies on to other agencies in the state. 

> Quality Tip of the Month | 

Evaluating the Client Experience 


Evaluating client experience is a key step in understanding how clients perceive your organization and the type of care they receive. Clients' perception of the care they receive and how they are treated plays a large part in whether or they will return to your facility. Simple things like easy-to-understand intake forms, making eye contact in exchanges with clients, and a concern for client privacy go a long way toward making them feel comfortable and at ease. You can make an impression on clients even before they access your facility. For example, a client's first contact can be via phone. Does your system present a warm greeting with easy to understand directions? If your phone system is staffed by a person, does that person present a pleasant manner? The little things are what sometimes make a difference between a bad experience and a pleasant one. Clients who feel comfortable and respected may be more likely to stay in care-our ultimate goal.

> National TA Call: Making Clients Feel Welcome 


First impressions are the most lasting and every organization should strive to make a positive impression the first time they meet a client. This month's National TA call, Clients at the Gate: How Welcoming are You?, will focus on the initial point of engagement of clients into your program. The call will explore:

  • What are the engagement points for your clinic/organization (how to identify them)?
  • What are the standards by which you are judging your clinic/organization engagement?
  • What are the ways you can improve engagement points in the clinic/organization using patient feedback?

National TA Call

November 21, 3:00-4:30 pm ET


To join | http://www.nqcqualityacademy.org/tawebinar/


To access the audio portion, dial 866.394.2346 and use passcode 3971546368


Remember, you do not need to pre-register for NQC TA calls any longer.


For more information | nationalqualitycenter.org/index.cfm/17403 

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.  


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


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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