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





Hopefully we have put the last of our winter weather behind us and spring is just a few days away. As we look forward to the coming months I want to remind you about another exciting season - the NQC Quality Award season.


Each year NQC and the HIV/AIDS Bureau recognize the work of grantees like you that have shown exemplary performance in various aspects of quality improvement. What makes this process difficult is picking applications that stand out because so many of the applications we receive demonstrate the deep commitment to quality management and outstanding performance measurement results that Ryan White grantee have achieved over the years. NQC and HAB urge you to be recognized for your hard work by applying for an NQC Quality Award that exemplifies your program's strength.

A brief reminder to you that we are holding our Training of Quality Leaders and Training on Coaching Basics Program in May and June respectively. Please see the details contained in this issue.




Clemens Steinbock

Director, National Quality Center


> In This Issue

> NQC News | NQC Quality Awards
> NQC News | 2014 Training Schedule: Sign Up Now
> NQC News | in+care Update
> Quality Corner | Jersey City Medical Center
> Consumer Perspective | Matthew Tochenhagen
> Quality Tip of the Month | Diffusion of Innovation
> National TA Call | Framework for Consumer Involvement

> NQC News | NQC Quality Awards


Don't forget. The deadline for applications is March 31, 2014. NQC encourages you to apply for an Award in one or more categories. So many Ryan White grantees have made such great strides in their quality management programs and it's important to be recognized for your efforts.


And there are two new Awards this year:

  • Award for Outstanding in+care Campaign Performance
  • Award for Consumer Involvement in Quality Improvement

To learn more | http://nationalqualitycenter.org/index.cfm/5847/17961

> NQC News | 2014 Training Schedule: Sign Up Now



Make 2014 the year that you build your quality-related skills! NQC is offering two trainings that are designed to meet the needs of the Ryan White community. Take a moment to see if either of these NQC trainings are right for you.


Training of Quality Leaders: May 6-8, Kansas City, MO

The TQL Program aims to build the individual capacity of quality managers and those who direct quality management programs to effectively lead and facilitate quality improvement activities. Participants will enhance their own expertise in quality management, build the skills needed to guide the development of sound quality management programs and quality improvement projects, and learn group facilitation skills to better address team dynamics. Participants leave the training with the skills for facilitating quality improvement teams, enhanced leadership skills, and access to a network of quality improvement experts.


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


Training on Coaching Basics: June, 9-11, Dallas, TX

The TCB Program focuses on building the quality improvement capacity of quality leaders to coach other HIV providers on quality improvement. It is designed for those individuals who currently work in Ryan White Program-funded grantees, are instrumental in managing existing quality management programs, and are charged in assisting other agencies within their HIV/AIDS network with advancing their quality management programs and quality improvement activities. Participants are expected to complete pre-work activities and months of post-course work. TCB participants must have successfully completed either the Training-of-Trainer or the Training of Quality Leaders Program (or both).


Learn more about and/or apply to the TCB | http://nationalqualitycenter.org/index.cfm/5847/37251

> NQC News | in+care Campaign Update 


The in+care Campaign has recently transitioned from its active phase to a sustaining phase. This means that the Campaign's activities will occur less frequently and, in some cases, will be folded into other NQC activities. The Campaign database and website, however, will continue to be available for many years to come, and so is the Partners in+care Facebook group. The Campaign webinars and newsletters will move to a quarterly schedule.


Campaign coaching activities are now being integrated into NQC continuous technical assistance portfolios. If you are a sub-grantee receiving technical assistance through the Campaign, you will now need to contact the agency that provides your Ryan White Program funding (the direct grantee) and ask them to request on your behalf.  


NQC will continue to support activities focused on retention in care, which is in alignment with the goals of the National HIV/AIDS Strategy. NQC is launching several other initiatives, including the HIV Cross-Part Care Continuum Collaborative (H4C) and a new, one-of-a-kind intervention sharing online platform (more details to come!).

Quality Corner | Jersey City Medical Center, Jersey City, New Jersey 


With over 1,000 patients, the Center for Comprehensive Care at Jersey City Medical Center, (funded by Ryan White Parts A, B and D) takes a very systematic approach to ensure that patients remain in care. At that heart of this effort is carefully documenting no-shows in a centralized database. Staff also regularly review patient records to determine those that are overdue for screenings or blood work. For those patients at risk of being lost to care, additional support is provided.


"Our biggest advantage in keeping patients engaged in care is using our data to track patients who are missing appointments so that they can quickly be rescheduled," states Christina Drake, senior data analyst. "We want to get them back in care as soon as possible since it is easier to reach them before too much time passes."


The Center offers a comprehensive array of services-outpatient care, medical case management, oral care, gynecologic services, mental health services, support services (e.g., transportation, psychosocial support), patient navigation, and HIV counseling and testing. With the exception of the oral health, all services are co-located. According to Christina, this allows providers take an interdisciplinary, team approach to retaining patients in care.


Efforts to retain patients start at the first appointment. The Center has a patient navigator program-designed as a case management/outreach hybrid-that supports new patients for their first three visits. The patient navigators provide intensive education, benefits enrollment, and orientation to the Center's services. They have a reduced caseload compared to medical case managers, allowing them to focus on new patients with an emphasis on meeting any needs that may create challenges related to accessing and remaining in care.


When an appointment is missed, the medical case manager follows up with the patient to make sure the appointment is rescheduled and determines if there are any additional issues confronting the patient. The medical case manager also follows up with the medical provider so that they know steps are being taken to re-engage the patient.


The Center's outreach team goes into the community to re-engage the hard to reach. The team-made up of two peers and a nurse-meet with the medical team and medical case managers to develop a strategy for each patient. The outreach team is in the community on a daily basis. In addition to following up on patients, they conduct educational events. The outreach nurse allows the Center to provide an extra level of care to patients. For example, she checks newly discharged and medically vulnerable patients. She also works with patients to support their adherence. Another nurse focuses on pregnant women and new mothers. She provides adherence education, teaches mothers to administer medication to their infants, and ensures that new mothers have an effective support system in place.


The Center takes a proactive approach when possible. Many new patients come to the Center from residential drug treatment programs. Medical case managers work closely with these patients to ensure that their immediate needs, such as housing, are met. By lessening the challenges confronting patients, it is more likely that they stay in care.


These various efforts have shown results in terms of the Center's retention rate. The rate of patients that are lost to care dropped from approximately 10 percent to 6 percent over a one-year period from July 2012 to September 2013. In addition, the Center's engagement rate for newly diagnosed patients is very high. From a nadir in May 2012 of 75 percent, the Center has achieved a sustained rate over 90 percent rate of retention for the entirety of 2013 ending in November 2013, with 94 percent successfully attending medical visits in each quarter.


For more information on the Center's activities contact Christina Drake at cdrake@libertyhcs.org.

> NQC e-Newsletter | Volume 6 | Issue 69 | Mar 14 


Quick Links


> Upcoming Events | April - May

> Upcoming Events | March - April 


March 20 | National TA Call | Framework for Consumer Involvement


March 31 l  Deadline for Quality Awards


April 17 | National TA Call | Care Continuum


May 6-8 | Training of Quality Leaders | Kansas City, MO

> Consumer Perspective | Matthew Tochenhagen


In small communities, sometimes people are asked to play multiple roles. Fortunately for Matthew Tochtenhagen, he has more than a decade of experience in HIV-related services, research, and prevention and outreach - so he is up to the challenge. Since 2011, Matthew has served as a case manager and life skills coach for AIDS Help in Key West, Florida. The organization, which receives Ryan White Part B and HOPWA funding, provides medical case management, physician services, food, housing assistance, emergency services, transportation, mental health/substance abuse counseling, and other supportive services to the primarily rural Florida Keys. In addition to his work with AIDS Help, Matthew is a consultant to the Monroe County Health Department where he serves as the quality management program coordinator for their Ryan White Part C activities.


"I have experienced things from all sides," says Matthew." When I guide people through the process of accessing services I can understand their stress and frustration, both from a personal perspective and based on my experience working across the HIV care continuum."


Last spring, Matthew attended the NQC's Training of Consumer's on Quality (TCQ). Despite his past experience he found the experience very valuable.


"The training helped me to come back and strengthen relationships in the community," says Matthew. "I now serve as a bridge between AIDS Help and the health department and am helping to create a seamless flow of information and services. When consumers go to the health department for services I can follow them and make sure that they get the care they need. We can do this in a small community like ours."


In addition to participating in the TCQ, Matthew has accessed NQC resources to strengthen the health department's quality-related activities. Prior to Matthew becoming the quality coordinator, the position had been vacant for over a year. Matthew has work with Judith Passela and Michael Hager from the NQC to get the program back up and running. Through the NQC, Matthew has also networked with other organizations and shared data.


"I'm excited to have the opportunity to work with other organizations," says Matthew. "This really helps a small organization build capacity. Often the focus is on big cities and communities like ours are forgotten. Through the NQC I have access to resources that otherwise might not be available."


For more information on Matthew's work contact him at matthew.t@aidshelp.cc.

> Quality Tip of the Month | Diffusion of Innovation


How are new ideas adopted within an organization? How are innovative ideas spread? It's very likely that you have asked yourself these questions in one form or another. Do you work in an organization that innovates, adopts innovative ideas very early on or does your organization tend to lag behind and see how the idea plays out before adopting it? In any case, diffusion is a complex process that is often driven by leaderships experience with innovation and their own unique personality traits. The reality is that these traits apply to all of us. At times, change can be a frustrating process. However, with a better understanding of what drives change and at what point change diffuses within an organization, you have a better chance of making the impact you seek. 


NQC urges you to take Tutorial 20 in the Quality Academy - Spreading Good Ideas for Change - to learn more about this interesting and complex topic. It's a valuable resource for those of you that confront this problem in your organizations.

> National TA Call | Aligning the Rubik's Cube of Health Care - Making Sense of Consumer Engagement



NQC is committed to promoting effective consumer involvement, both in our own work and the work of Ryan White grantees. This month NQC Coach Adam Thompson will be leading us through a discussion on this new topic. Each quarter, NQC has a call on an aspect of engaging consumers in quality improvement work. As you can see from our learning objectives this month, the Engaging Consumers in Health and Healthcare (ECHC) framework is the basis for our call.


Learning Objectives:

  1. Introduce the ECHC framework as a tool for "making sense" of consumer engagement in health and health care
  2. Identify the fundamental elements of consumer engagement in the ECHC framework.
  3. Make recommendations for how the ECHC framework could be used in quality improvement activities

Join Us! | March 20th @ 3:00 PM (ET). To obtain the link to sign in | nationalqualitycenter.org/index.cfm/17403



Don't forget NQC has many publications on aspects of consumer involvement. Please check the website and conduct a search on "consumer involvement."

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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