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.





This month NQC wanted to point out the successful and continuing efforts of the DC Collaborative. In 2012, the DC Collaborative transitioned from an NQC-facilitated collaborative to a self-sustaining and self-directed Collaborative. Thanks to the efforts of its members, this Collaborative is still functioning to this day and shows no sign of slowing down. Check out the great work still going on in the NQC Update article.


Another focus this month are the topics of mental health and viral load suppression. We are pleased and honored to have JoLynn Wheatley from the Nationwide Children's Hospital's Family AIDS Clinic and Education Services who has developed a wonderful presentation on this important topic. We hope you find it as informative as her colleagues have.  Check out the TA Call Section



Clemens Steinbock

Director, National Quality Center

> This Issue

In This Issue...

> NQC Update | DC EMA Collaborative Update  



"The DC Collaborative has been such a great experience," says Justin Britanik, quality management specialist for the HIV/AIDS Administration at the District of Columbia's Department of Health. "Those of us involved have learned so much through this journey."


The DC EMA Collaborative is still going strong, even though the NQC's role as facilitator ended in May 2012. The goal of the Collaborative was to foster cross-Part alignment, partnership, and collaboration among regional grantees and stakeholders serving the DC metropolitan area while advancing the quality improvement (QI) infrastructure across the entire EMA. Additionally, the DC Collaborative was designed to help create a common QI vision in the EMA, build the capacity of providers to carry out QI activities, support joint QI projects, reduce the data collection burden, and increase the involvement of consumers in these activities.


A major focus of the DC Collaborative was on capacity building. These efforts were guided by the Response Team, which was, and still is, made up of volunteers from health departments, subgrantees, and consumers across the EMA. Quarterly QI trainings were provided for frontline staff and consumers that included Quality 101, performance data collection and use, and the HRSA/HAB performance measures.


"We helped them see how their work fit into overall quality improvement activities," says Justin. "They learned about the performance measures and how what they were doing tied into the measures-everyone from clinicians, case managers, and even front desk staff plays a role in meeting the measures."


Another area of focus was data collection. At the start of the Collaborative the various jurisdictions and subgrantees in the EMA collected and reported data in many different ways. Through the Collaborative, members looked at ways to streamline the data collection and reporting process, as well as provided input on the selection on the performance measures to be tracked. Now, every jurisdiction and subgrantee in the EMA is using CAREWare.


"We can now compare data across providers," says Justin. "They can see how others are doing, compare outcomes, and the competition about outcomes is all in fun. Exploring outcomes opens the door for sharing best practices."


Consumers played an important role in the work of the DC Collaborative. They were involved at all levels, including the Response Team. During the DC Collaborative, consumers formed Advocates for Quality, a group of consumers supported by the DC Department of Health that trains consumers to become more involved in their own care and quality improvement-related activities.


Since the DC Collaborative officially ended, the Response Team has continued to meet. The primary focus of these activities is to plan for and provide ongoing training and team building opportunities. Quarterly, full-day trainings are offered and open to all-QI staff, case managers, data managers, program managers, and consumers - across the EMA. The quarterly trainings provide an opportunity to review progress on the Quality Management Plan and joint QI projects. An annual face-to-face QI Summit, in collaboration with NQC, is also held to continue the skills building that was so vital in the original Learning Sessions.


"Staff turnover at the subgrantee level is very high so there will always be people that need basic quality training. In addition, we have people who have gotten really savvy about quality. We need to provide training at a variety of levels," says Justin. "We also try to make it fun. At this point we have gone through every game in NQC's Game Guide and developed some games of our own."


The DC Department of Health plans to continue to support the work of the Response Team and the Advocates for Quality.


"It is something that we put a lot of effort into but we see the return in the participants and what they get out of the trainings," says Justin. "We are planting seeds for the future."


For more information on the DC EMA Collaborative | http://nationalqualitycenter.org/index.cfm/17112/38159

> Provider Corner | Open Door of Greater Elgin, Elgin, IL  



Institutional memory can be a valuable asset in quality improvement-related activities-knowing an organization's past can help to guide it into the future. Pat Lev has worked at Open Door of Greater Elgin for over 25 years. When she joined the organization as a case manager, there were two other employees. Now, there are 35.


Open Door's initial focus was providing testing for sexually transmitted diseases. In the early days of the AIDS epidemic, HIV counseling and testing was added. To address the needs of those that tested positive, Pat was was hired as a case manager in 1990. In 1993, services were once again expanded. This time it was to meet the needs of HIV-infected clients by providing access to HIV medical care. Since this time, Open Door has been a recipient of Ryan White HIV/AIDS Program Part A, B, and C funding. Clinics are based in Elgin and Aurora, Illinois.


In response to growing caseloads and growing staff, quality improvement was integrated into Open Door's activities and Pat began dividing her time between QI and case management in 2000.


"I bring a unique perspective. I am involved personally with clients through case management and am also focused on the data," says Pat. "It is not just about the numbers but the story that the data tell. It is about us and how we are doing."


Pat isn't the only person on staff focused on quality. Every staff member-from physicians, to case managers, to the receptionist-must conduct a QI project each year. Pat makes sure they have the tools they need by conducting annual trainings for all staff and quarterly trainings for new staff. Projects have focused on improving Pap rates, ensuring that care plans are completed, and improving viral suppression.


Consumers are also involved in quality activities. The chair of the consumer advisory board (who later became a peer navigator for Open Door Clinic) initiated an activity focused on retention in care. Consumers are given a participation card. They need to have clinicians (physician, case manager, therapist) sign off that they attended three appointments over the course of the year. They also had to check off their participation in the four social events for consumers and their families that are held each year. Those that attended all the activities are entered in a drawing. The 12 winners are treated to a festive dinner party.


Ongoing consumer involvement is especially important at this time in Open Door's development as in the clinic is in the process of applying for patient-centered medical home (PCMH) recognition. Open Door conducts consumer satisfaction surveys twice a year, with a participation rate of approximately 20 percent. The survey has been aligned to reflect PCMH requirements.


Pat has honed her quality improvement skills over the years at NQC trainings-she has achieved the NQC trifecta (Training-of-Trainers, Training of Coaching Basics, Training of Quality Leaders Programs). She also participated in regional activities conducted by NQC. NQC helped Pat develop Open Door's first written quality management plan.


Like the NQC, Pat is embracing technology to spread the message of quality improvement. She is exploring providing upcoming staff trainings online. This would make them available to staff at any time and archived versions would be available to new staff. Since staff training is an ongoing process, making some of the training offerings available electronically would allow Pat to focus on other aspects of the QI process.

> June 2015 | Issue 79 | Vol 6 

> NQC 10-Year Anniversary
Milestones and Highlights

Tell us how NQC has helped you!

> Upcoming Events | June 

June 18  l  National TA Call  l  Mental Health and Viral Load Supression

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.

> Consumer Perspective | Kevin Uhrin  



"I came away from the NQC training so inspired," says Kevin Uhrin. "I've always been involved in as many things as possible but after the training I wanted to do even more."


It is hard to imagine Kevin being more involved. Currently, his list of activities is extensive. He is on the consumer advisory board for the New York State Department of Health AIDS Institute and he is on the HIV consumer advisory board in Queens. He also serves on the consumer advisory board of the NYC Police Commissioner dealing with all LGBTQ issues throughout the city. He volunteers at Harlem United where he serves as an Enrollment Project volunteer for Affordable Health Care initiatives. He also does fundraising forAID for AIDS International and Live Out Loud.


His volunteer work provides him an opportunity to advocate for other consumers and provide "hands on" assistance. For example, at Harlem United he was active in outreach to help people enroll in health insurance.


"We went out in the community and conducted seminars and worked with people one-on-one," says Kevin. "No matter who you are you have a right to health care and we reached people who thought they would never have health insurance."


Despite being a long-time HIV survivor-he was diagnosed in the 1980s-and his extensive volunteer and advocacy resume, Kevin came away with from the 2013 NQC Training of Consumers on Quality with new skills and a fresh perspective.


"I learned so much about the State Health Department and all the assessment and research they conduct and how they use the findings to improve outcomes," says Kevin. "I also learned from the other participants-what they have gone through and the great things they are doing in their communities."


Following the trainings Kevin met with some providers in his community to share what he learned.


"Not just consumers need this type of training," says Kevin. "Providers need to learn what they can do to support engaged and motivated consumers. They need to know how to support their consumers in asking the right questions and taking control of their health care."

>Quality Tip of the Month | Addressing Mental Health Issues 



According to the HIV Costs and Services Utilization Study (HCSUS), nearly 50 percent of adults being treated for HIV also have symptoms of a psychiatric disorder. This is 4 to 8 times higher than in the general population. Nineteen (19) percent of patients studied showed signs of substance abuse, and 13 percent had co-occurring mental illness and substance abuse disorders.


Diagnosis and treatment of mental health issues are essential to the physical health and quality of life of people living with HIV/AIDS (PLWH). Untreated mental health issues can make it more difficult for PLWH to:

  • Take all HIV medications on time;
  • Keep appointments and take advantage of support networks;
  • Maintain healthy behaviors (sleep, exercise, avoiding risky behaviors); and
  • Cope with the stresses of daily life.


In recognition of the importance of mental health treatment, the HRSA HIV/ADIS Bureau has included screening for depression and screening for substance use as performance measures. Resources are available for both clinicians and patients to help them address mental health issues within the context of HIV care.


To learn more about mental health, visit the TARGET Center:


 > National TA Webinar | Mental Health and Viral Suppression



The June TA Webinar will explore the issue of mental health and how screening and effective treatment can improve health outcomes and move patients toward viral suppression.


Learning objectives include:

  • Address the prevalence of mental health disorders among people living with HIV.
  • Identify screening tools used to assess for depression, anxiety, and substance use.
  • Develop strategies to integrate treatment of mental health disorders into HIV medical care.
  • Identify barriers and challenges related to implementing an integrated model of mental health treatment and HIV medical care.


The TA webinar will take place June 18, 3:00 - 4:30 pm ET.


Meeting information
Topic: Mental Health and Viral Load Suppression
Date: Thursday, June 18, 2015
Time: 3:00 pm, Eastern Daylight Time (New York, GMT-04:00)
Meeting Number: 641 415 492
Meeting Password: nqctacall114

To start or join the online meeting
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Audio conference information


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Local: 1-518-549-0500 or Toll Free: 1-844-633-8697
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> About Us


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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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