> NQC News | Meet Our CAC Members

Last year, NQC brought new members onto our Consumer Advisory Committee (CAC). These new representatives will serve 2-year terms during 2014-2015. They represent the geographic diversity of the country as well as the diversity of the HIV epidemic. Through the CAC, HIV-infected and affected consumers provide critical input to NQC to develop initiatives that improve the quality of HIV care. The CAC holds conference calls to discuss issues that impact Ryan White consumers and providers and the role of NQC in addressing these issues.

Learn all about new CAC members (some may be from your own community) by viewing their profiles on the NQC website | http://nationalqualitycenter.org/index.cfm/5847/8795    

> Provider Corner | Coastal Family Health Center

Since it is football season the use of a football analogy seems appropriate. A huddle is not only a successful strategy in football but it can also be a valuable quality improvement tool.

Coastal Family Health Center is a Part C-funded Federally Qualified Health Center providing services to approximately 450 people living with HIV in a three-county region around Biloxi, Mississippi. As the clinic's medical case manager, as well as the adherence specialist and the quality improvement expert, Meagan Parker, LCSW, is focused on bringing about systemic improvement. One of the ways she has done this is through the morning huddle. The huddle brings together Meagan, the medical provider (either doctor or nurse practitioner), nurse, and the program manager. They review the consumers' charts, discuss consumers' needs and challenges, and strategize how to address. For example, transportation can be a significant issue, not only to appointments but to pick up prescriptions at the pharmacy. The state's ADAP will soon be providing mail order service so this will help to provide consumers easier access to their medications.

Monitoring consumers through this process has resulted in the clinic achieving a level of viral suppression that is very high for the region-over 70 percent, (in addition to other initiatives). Use of the huddle will also be helpful as the clinics moves toward certification as a patient-centered medical home.

In addition to the huddles, the clinic has been much more aggressive in following up on no-shows - there is a no show rate of 20 percent at their clinic. Currently, if a consumer does not show up for an appointment the clinic follows-up within 24 hours and a new appointment is scheduled. This has been effective in bringing many consumers back into care. They are conducting a PDSA cycle on no-shows to identify additional strategies to help consumers keep their appointments and to explore why consumers drop out of care.

Meagan is slated to attend the NQC's Training-of-Trainers in November being held in Las Vegas, NV. This will help her build her skills so that she can provide training to others in her organization and the wider community.

"I have a passion for quality and I want to be able to come back and present to others in my organization," says Meagan. "With buy in from the administration, staff, and the consumers we have seen we can really make a difference with our quality-related activities." 

> Consumer Perspective | Jennifer Bullock

For many of us, a full-time job is enough. Not for Jennifer Bullock. After putting in her hours as a travel agent, Jennifer is active in HIV planning and quality-related activities at the local, state, and national level.

"I love my job and I love volunteering. It is the perfect balance," says Jennifer. "While I sometimes feel a bit out of the loop not being totally immersed in HIV like peer educators or navigators, I feel I can bring a different perspective."

Jennifer is a member of Arizona's Ryan White Planning Council and is active on the Training, Education and Membership (TEAM) committee. Over the last year, the TEAM committee was involved in supporting enrollment of Ryan White consumers in Affordable Care Act (ACA)-supported health insurance. TEAM committee members worked with providers to help them engage consumers in discussions around enrollment and track which consumers had been enrolled. Jennifer made presentations to consumers and explained the enrollment process.

Jennifer is also a member of the Phoenix EMA (Part A) CQM committee

At the national level, Jennifer is a member of the NQC's Consumer Advisory Committee and also took part in NQC's Training of Consumers on Quality in spring 2013 in Atlanta, GA. Because she is not involved in HIV-related work on a daily basis, she has found her participation in NQC activities especially valuable.

"It was great to be in a meeting where everyone was positive. Often I am around people who are not that knowledgeable about HIV," says Jennifer. "It was so valuable to hear their perspectives and challenges and to be able to discuss things freely."

Hearing from others is important to Jennifer because she wants to see how their experiences and challenges impact retention in care and adherence to treatment.

"Since I've been on my medication I have never missed a dose," says Jennifer. "I want to hear other consumers' perspectives on this so that I can share their experiences as well as my own. Understanding the various experiences will help us better support retention and adherence."

> Upcoming Events | November - December

November 20 | National TA Call | Top Ten Reasons Why Your PDSA Cycles Fail and What to Do About It

December 1 | Launch of NQC's 10-Year Anniversary

December 3 | in+care Campaign data due

December 18 | National TA Call | Quality 101 - Back to Basics

> Quality Tip of the Month | PDSA Cycle (Part 2) - Get Set

A journey of a thousand miles begins with one step. While a PDSA Cycle in no way compares to an arduous journey, sometimes getting started can be a bit challenging. Your Aim Statement is your first step, but now what? Planning is a key component of the PDSA Cycle and requires you and the quality committee to think through how you want to accomplish your change. Think about how you will carry out the test; who will be involved, what resources are required, how long is the initial test, who will analyze the data. The list goes on and on but the lesson is that this is the next step in having a PDSA Cycle that will inform changes within your organization.

"Failing to plan is planning to fail." - Alan Lakein 

Check out this NQC resource on PDSA Cycles:

Quality Academy: Tutorial 13, The PDSA Cycle or How Can We Accelerate Improvements in HIV Care?

This tutorial focuses on the PDSA Cycle: what it is, how it fits into the Model for Improvement, why it is important, and how to use the PDSA Cycle in HIV programs. The module provides numerous examples and tips for success to help people avoid pitfalls and easily integrate this model in their quality improvement activities.

http://nationalqualitycenter.org/index.cfm/6101/15947 

> National TA Call | Top Ten Reasons Why Your PDSA Cycles Fail and What to Do About It

Join us this month when Lori Delorenzo - a long-time NQC Coach - presents "The Top 10 Reasons Why PDSA Cycles Fail, And What To Do About Them". Shamelessly drawing from David Letterman's top 10 list, Lori has been collecting examples from grantees across the country on some of the pratfalls they have had with PDSA Cycles. Remember; the first rule of the PDSA Cycle is to learn, not necessarily to succeed. The PDSA Cycle is repeated tests of change until such time that all the flaws have been worked out of your idea and it can be instituted organization wide. At the end of this call you will have a greater appreciation of the lessons that your peers have learned and how they used the 'failures' to eventually achieve success.

"Success is stumbling from failure to failure with no loss of enthusiasm." - Winston Churchill

To add this Webinar to your calendar program (for example Microsoft Outlook), click this link:
https://meetny.webex.com/meetny/j.php?MTID=mc5b7f0a1370fa92336266aacf3722d32
 

For more information and the link | nationalqualitycenter.org/index.cfm/17403  

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 | newsdirector@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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