Celebrating 10 years of leading innovations across the Ryan White community.


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




We want to share two interesting profiles in this month's edition of our e-Newsletter. The work of Family Health Centers and Christa Reece's work at Harlem Hospital exemplifies the meaning of teamwork to accomplish quality improvement goals to advance HIV care. For more information, check out our "Provider Corner".


Our quality tip this month also focuses on the importance of working in quality teams to reach your improvement goals. For those of you that have participated in past NQC trainings, you are well aware of the importance of working as teams and what you can accomplish when the team is focused and efficient. Take a look at the resources that we suggest this month.


NQC welcomes input from all of you. Have you found helpful resources for teams? If you have and would like to share them, let us know and we would be happy to pass them along to the Ryan White HIV/AIDS Program community.


Tell us how NQC has helped you | Submit Your Testimony  




Clemens Steinbock

Director, National Quality Center

> This Issue

> NQC Offer | Need QI Resources for your Next Quality Event?  


NQC is ready to help you make your next quality conference or training a success. Over the years, NQC has been invited to participate in many regional training and conferences on a local, state-wide or regional level. We want to remind you that this is a service is still available to you. NQC can offer its plethora of quality improvement materials, our developed content and our cadre of expert consultants to help make your quality conference or training a success. We can help you structure quality improvement learning sessions and assist you in defining your vision for your event. Let us know how we can help.


To see the resources NQC can offer you | http://nationalqualitycenter.org/index.cfm/5852


Contact us | Kevin Garrett at Kevin@NationalQualityCenter.org  

> Feb. 2015 | Issue 76 | Vol 7 

> NQC 10-Year Anniversary
Milestones and Highlights

Tell us how NQC has helped you!

> Upcoming Events 

Feb. 2015

February 1 | in+care Submission Due Date


February 4 and 5 | H4C Learning Session, Rockville, MD

February 19 | National TA Call - Clients at the Gate: How Welcoming Are You?

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



Improving HIV Care.

> Announcing the Georgia Regional Group


The Georgia Part B Core Quality Management Group and the National Quality Center have joined forces to launch the Georgia Regional Group. Participant sites range from small rural to suburban clinics to high-volume urban programs. They are also geographically diverse and thus Regional Group members meet via a Webinar platform. To date the group has covered topics ranging from Ryan White HIV/AIDS Program quality expectations, quality management 101, Lean concepts in healthcare, PDSA cycles, and fishbone diagrams associated with these topics. In the months ahead the group will be covering topics related to the various steps along the HIV Care Continuum as well as clinical and service interventions that lead to enhanced quality and better patient outcomes. Despite the diversity of grantee participants, synergistic HIV topics and quality improvement trainings are applicable across settings, levels of experience, and Ryan White HIV/AIDS Program Part. 


Learn more about NQC Regional Groups l http://nationalqualitycenter.org/index.cfm/5847/82137

> NQC Reminder | in+care Campaign Database - Your Benchmarking Resource 


Even though the in+care Campaign is in its sustaining phase, we still are able to offer you our active database that is replete with the information most valuable to grantees - benchmark data.  In addition to the being a repository for your own performance data over time, the in+care database has valuable information from over 200 grantees that have participated in the in+care campaign. Over one hundred of these grantees are still entering data to this day. 


It's still not too late take advantage of this invaluable resource.  Go to http://database.incarecampaign.org/ and click Create Account.  Once you start to enter data, you can track your performance measures and can also obtain benchmark data using a variety of filters. 


To learn more about the in+care Campaign | http://incarecampaign.org/

NQC 10th Anniversary | Reflections from the Field


In celebration of NQC's 10 years of service to the Ryan White HIV/AIDS Program community we have asked some NQC staff and consultants to reflect on their work over the years:


"More than 200 individuals living with HIV have participated in our Training of Consumers on Quality initiative as of this issue. I'm proud that NQC continues to fulfil our program goals to ensure that health care users have the skills to be engaged in Ryan White HIV/AIDS Program quality management and quality improvement activities to enhance quality of life and health care outcomes for people living with HIV. The training often comes full circle as several members of NQC's Consumer Advisory Committee-who have participated in these consumer trainings themselves-have assisted NQC in delivering the Training of Consumers on Quality program in their respective states."

Dan Tietz, Manager, Consumer Affairs


"As a coach I get to see over time the impact of NQC's technical assistance. I worked with a large private, non-profit hospital located in a low-income neighborhood serving over 1,000 people living with HIV. In 2010, the center asked for help to build an HIV quality management (QM) program. While management was on board, staff were very resistant. At the time the QM plan was very vague, there was no team effort to improve quality, no quality-related projects had been implemented, and there was very limited engagement of consumers. Today, quality improvement (QI) has been woven into the fabric of the center's work. Performance measurement, staff training, and QI projects are ongoing. Their efforts include:

  • The coordinator, medical director, and medical case management supervisor actively lead ongoing QI efforts.
  • The QM plan includes annual, measurable goals, and an annual work plan (month-by-month calendar) to operationalize the QM plan into QI activities.
  • There is a robust, multidisciplinary QM committee that meets quarterly and reviews data-not only data required by outside agencies, but also data on measures selected by the HIV clinic team.
  • Over the past four years the QM program has implemented a series of successful QI projects focused on cervical cancer screening, depression screening and care, STI screening and treatment, and HIV viral suppression.

The most rewarding thing is that the QI efforts have resulted in good outcomes for consumers. Eighty (80) percent of clients now have suppressed viral loads, and that rate has increased by 3 percent over the past eight months."

Dan Sendzik, Coach, National Quality Center
> Consumer Perspective
Provider Corner | Family Health Centers of San Diego



Family Health Centers of San Diego (FHCSD) is a federally qualified health center (FQHC) that has been providing health care services since 1970. The agency currently offers services out of 35 sites, including 18 primary care clinics. It is the largest provider of comprehensive HIV prevention, outreach, education, testing, and support services in San Diego County, CA, with over 2,000 HIV-infected patients currently receiving care and support services.  FHCSD also provides individual and group level HIV prevention and harm reduction services, as well as HIV testing services county-wide.  Last year, FHCSD provided over 14,000 HIV tests, including more than 5,000 tests at over 70 residential substance abuse treat programs.


FHCSD, through a Part C or D grant, provides a comprehensive array of services to people living with HIV-including medical, mental health and dental care, as well as services to address issues that may act as barriers to retention in care, including case management and outpatient substance abuse treatment and risk reduction services. FHCSD also offers population-specific programs to meet the specific needs of underserved groups in the community, such as services for transgender individuals, homeless individuals and young gay men of color. Since opening their HIV specialty clinic in 1989, The Ciaccio Memorial Clinic, FHCSD has focused its efforts on the provision of high-quality services that meet the changing needs of the HIV community in San Diego. Since that time, the center's HIV-related services have continued to grow into a comprehensive system of care, all located within a several blocks radius. This "one-stop shopping" environment of care greatly enhances cross referrals by staff and completion of those referrals by patients.  It also supports direct and timely linkage to care for newly diagnosed or enrolled patients.


The Ciaccio Memorial Center  works hard to support patients to achieve better outcomes, with a focus on retention in care and adherence support. For example, to increase Pap smear rates FHCSD held a "Day of Beauty" event. HIV-infected women were invited to a 4-hour event where they were provided makeovers and also received Pap smears. Transportation and refreshments were offered to increase attendance. As a result, almost 70 percent of FHCSD HIV-infected female patients received a Pap smear this year, up from 32 percent the previous year. Other areas of focus for upcoming quality improvement projects include reducing wait times for appointments and reducing the number of missed appointments. In the near future, FHCSD will begin piloting a project to send text messages to patients to remind them of upcoming appointments.


FHCSD has participated in the NQC's regional group for the San Diego area and has worked with the NQC coach to build up their quality management program. In January, FHCSD hosted a Quality 101 training for other providers in the region.


"We rely on utilization and outcome data, as well as input from patients to identify opportunities for improvement," says Verna Gant, program manager for HIV support services. "Both our HIV Quality Committee and consumer advisory board each meet regularly to identify new quality improvement projects, establish goals and plans for improvement, and then review progress on current projects."


Another of FHCSD's projects, which focused on adherence and retention, has also paid off. Approximately 83 percent of patients have achieved viral suppression and 75 percent of patients have been retained in care.


If you would like to learn more or have follow up questions, contact NQC and we will make your connection with this grantee | info@nationalqualitycenter.org
> Consumer Perspective | Christa Reece


It takes a home girl to get things done. Christa Reece was born in Harlem Hospital and raised in the neighborhood. She was diagnosed with HIV in 2004. In 2005 she began doing community outreach through Harlem Hospital to link people to rapid HIV testing. In this position, she received training on how to provide peer-based education.


She then became involved in providing risk reduction counseling and education through the New York City Health and Hospitals Corporation's Harm Reduction Program. This program offers HIV counseling and testing as well as linkage to a wide array of services. This support is very intensive-even calling consumers to ensure that they had taken their medication.


"We served as their buddy system," says Christa. "We made them feel like they were part of a family."


Her work now focuses on tracking outcomes. She is serving as secretary of the consumer advisory council and is also working to enter data.


"I attended the NQC's Training of Consumers on Quality in Philadelphia and it provided me with an understanding of how data can be used to track HIV care," says Christa. "It gave me a better understanding of how data tracks the virus at various levels."


While she has served in multiple positions, Christa's motivation remains the same.


"I am focused on giving back to my community," she says. "I am the poster girl for my community. I want people to know that they don't need to be ashamed to be living with this virus."
> Quality Tip of the Month: Using Teams to Improve


Apropos of the recently completed Super Bowl (and the Puppy Bowl), this month's tip is about the importance of teams in quality improvement work.  In past tips, we have talked about the importance of the AIM Statement and running PDSA Cycles to test ideas for change.  The underlying assumption has been that you have teams to accomplish the work specified in your quality management plan. 


The team is of vital importance in quality improvement work.  Peter Scholtes wrote The Team Handbook; recognized as the seminal work on teams and their importance. In it he states that the need for teams is clear when the task is complex, fast learning is key, there is a need for high commitment and the task is cross functional to name a few.  A team needs commitment from senior leaders but it should also concentrate on the detail work as well such as taking minutes, identifying a qualified facilitator, and have a time keeper to keep all on track.  The team should identify priorities, and work as a group toward a common goal.  The team should foster an environment of non-judgmental sharing of ideas.  Remember, teams are a living entity; they will go through stages of growth and they need to be constantly nurtured with the energy of its members. 


To learn more about teams, please visit these resources:

February 19 | National TA Call | Clients at the Gate: How Welcoming Are You?


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?


Meeting information
Topic: Clients at the Gate: How Welcoming Are You?
Date: Thursday, February 19, 2015
Time: 3:00 pm, Eastern Standard Time (New York, GMT-05:00)
Meeting Number: 644 219 504
Meeting Password: nqctawebinar114
To start or join the online meeting

Go to https://meetny.webex.com/meetny/j.php?MTID=m6e4fca98bdcae1689a18c646289beb3b


To add this meeting to your calendar program (for example Microsoft Outlook), click this link:
> 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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