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




We are at the "half-way" point in what I hope has been a wonderful summer for you all. 

NQC is in the process of kicking of its 10-year anniversary since its initial funding in September 2004. We have some surprises for you which we will share in the coming months. All of us at NQC want to thank you for putting your trust in us to help you improve your clinical quality management programs. I know I speak for everyone in NQC when I say it has been a wonderful journey and all of the NQC staff looks forward to the next 10 years and beyond. 

We highlight two important pieces in this month's newsletter.  First, we congratulate the winner of this year's NQC Quality of Care Award for Leadership, Shaundelyn DeGraffenreidt. Her accomplishments speak for themselves and she was the unanimous choice of the review committee. Her accomplishments are highlighted to provide learning opportunities for others.


Secondly, NQC is pleased to offer a National TA Webinar in conjunction with the HIV/AIDS Bureau (HAB) on oral health. Tracey Gannt, RN, MSN (HAB project officer), Mahyar Mofidi, DMD, PhD, (HAB Chief Dental Officer and Branch Chief), and Karen Daniels (Quality Data Analyst) from CommWell Health (Ryan White Part C and D funded grantee in Newton Grove, NC) will present. We hope to have an interesting discussion on a very important topic that at times is overlooked. 




Clemens Steinbock

Director, National Quality Center


> In This Issue

> NQC News | Perspectives from a Quality Award Winner
> Consumer Perspective | Sandrine Lewis
> NQC Job Forum | Check it Out!
Quality Tip of the Month | Oral Health
> Upcoming Events | August - October

> NQC News | Perspectives from A Quality Award Winner  


This year's winner of the NQC's Award for Leadership in Quality, Shaundelyn DeGraffenreidt, has been responsible for carrying out a wide range of quality-related activities and has helped transform the Fort Lauderdale/Broward County, Florida EMA's Clinical Quality Management Program into a nationally recognized model of excellence. Broward was the winner of NQC's 2012 Quality of Care Award for Performance Measurement. Shaundelyn has served as the EMA's Quality Assurance Coordinator for the last three years where she directs quality activities across a network of thirteen (13) funded providers who serve an estimated 7,100 Part A consumers annually. Her commitment to improving health outcomes in disenfranchised communities is rooted in her first position as an organizational effectiveness analyst for a large hospital system where she developed a deep understanding of the impact the quality improvement activities can have in clinical settings.

One of the major initiatives that Shaundelyn has led is the restructuring of the EMA's Quality Improvement (QI) Networks. The Networks are made up of funded Part A subgrantees representing all locally funded Part A service categories. There are five Networks:

  • Outpatient/ambulatory medical care,
  • Medical case management,
  • Mental health/substance abuse,
  • Oral health care, and
  • A combined network covering centralized intake and eligibility determination, food bank, pharmacy, and legal services, housing (e.g., HOPWA), and Part B-funded transportation services.

Participants are mostly direct service providers (e.g., physicians, case managers) and their managers. This ensures that the work is very hands on and reflects the reality in the field. The Networks work together if they are addressing similar issues. Holding joint meetings allows participants to learn from each other and breaks down the boundaries between service categories. 

Before the restructuring, the Networks were run on a very formal basis. Each Network meeting tended to focus on a specific topic-there was no coherence from meeting to meeting and the Networks did not engage in long-term projects. Now, the Networks are more action oriented. Each network has an annual work plan that reflects the goals of the EMA's Comprehensive Plan, which is developed by the Planning Council, and the 3-year Quality Management Plan.

The restructuring of the Networks coincided with the launch of the in+care Campaign. To align their work with the Campaign, each of the Networks focused on retention and the Campaign's performance measures.Each month Networks analyze the Campaign measures through the use of client-level and service category specific reports.  These reports were used to identify barriers and challenges to retention in care.  

"Participating in the Campaign helped drive the process," says Shaundelyn. "It gave us something concrete to work toward. By focusing on retention for the length of the Campaign we were really able to go back and see if there had been improvement in this area."  For example, the EMA has improved the number of patients with a kept OAMC visit in the last 180 days from 70% in FY2011 to 80% in FY2012 and 82% in FY2013.

One of the major functions of the Networks is helping to address systems issues. They have played an important role in identifying the data necessary to measure performance, especially at the client level, and provided suggestions on how to streamline data collection and reporting processes. Since the Networks bring together providers from across the EMA they have also been valuable in identifying training needs. For example, the EMA conducted trainings on depression for clinicians and case managers when data indicated that a significant number of consumers suffer from depression and these consumers are more likely to drop out of care.

"We have so much data that there is a tendency to want to focus on everything," says Shaundelyn. "You need to prioritize what you will measure. The Networks have helped to guide this process."

> Consumer Perspective | Sandrine Lewis


Sandrine Lewis considers herself both a part-time patient navigator and a volunteer with John Wesley Community Health (JWCH), which provides a wide range of services such as health care, health education services, drug treatment services, psychosocial assessment and intervention, and support services to underserved populations in Los Angeles County, CA.   JWCH's also provides HIV testing, case management, and support services.


Sandrine works with the Health Alternatives for Reducing the Risk of HIV program, which targets men and women at risk who may be dual diagnosed-at risk for HIV or STDs and experiencing substance abuse. It provides an individualized behavior change plan for each participant based upon an assessment of readiness to change with respect to HIV risk behaviors. Working in areas like Los Angeles' Skid Row, she puts in long hours helping clients link to, and remain, in care. While some of the challenges faced by this population were expected, such as mental illness, substance abuse, and unstable housing, Sandrine also helps her clients confront the stigma and discrimination associated with HIV.


"They are afraid that someone may see them taking their medication or going to an appointment and discover their status. They have a lot of fear," says Sandrine. "I work with them and use my own story as an example. I emphasize the importance of taking care of oneself so that you can do the things that you need to do."


Sandrine also volunteers as a peer navigator with JWCH's Ladies of Diversity program, which assists HIV-infected women to obtain treatment by making appointments and then helping to ensure that they keep it. Sandrine is also an advocate for women living with HIV. She is a member of the consumer advisory board of the Females of African American Legacy Empowering Self (FemAALES) Project and the Los Angeles Women's HIV/AIDS Task Force. Both organizations work to ensure that women-focused services, such as support groups, are available.


Sandrine attended NQC's Training of Consumers on Quality in spring 2013. She found the information about quality care and retention, especially the patient self-management materials, valuable in her work as a patient navigator. "When I was diagnosed, I felt as though the providers I spoke with were not walking in my shoes," says Sandrine. "When a consumer talks to another consumer they can relate."

> NQC e-Newsletter | Volume 7 | Issue 72 | Aug '14


Quick Links


> Upcoming Events

> Upcoming Events | August


August 21 | National TA Call

August 26 & 27 | H4C Learning Session II

NQC Job Forum| Check it Out! 


Just a reminder that NQC has a Job Forum section on our website.  The Job Forum lists quality improvement related positions from Ryan White Program grantees.  Currently, there are two postings for your review. 

NQC encourages you to send us your posting for review and placement in the Job Forum.  And of course, this service is of no cost to Ryan White Grantees. 

> Quality Tip of the Month | Oral Health 


Oral health is an important part of overall health for people living with HIV.  To help ensure that Ryan White consumers receive the oral health care that they need, HRSA/HAB has develop performance measures in the following areas:

  • Dental and Medical History
  • Dental Treatment Plan
  • Oral Health Education
  • Periodontal Screening or Examination
  • Phase I Treatment Plan Completion

To view the HAB Oral Health Measures  l  Click here

The TARGET Center offers a wide range of resources related to the provision of quality oral health care to people living with HIV.

To visit the Target Center website  l  Click here

> National TA Call | Oral Health


This month's webinar focuses on oral health. NQC is pleased to offer this National Webinar in conjunction with HAB. Mahyar Mofidi, DMD, PhD from HAB will be discussing why oral health is so important to HIV-infected individuals.  After that, you will hear from Karen Daniels of CommWell Health about their dental program and what they have done to encourage oral health in their patients. 

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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