MOPE491 - Poster Exhibition
Improving HIV care through peer learning collaboratives
C. Steinbock1, M. Vohra1, M. Hager1, L. DeLorenzo2, J. Caruso3, K. Clanon4, B. Boshard5, S. Sulaiman1, R. Chaufournier6, T. Matthews7, M. Matosky7, B. Agins1, M. Palumbo1
1New York State Department of Health AIDS Institute, New York, United States, 2Organizational Ideas, Blacksburg, United States, 3Family Centered HIV Care Network, Trenton, United States, 4Pacific AIDS Education and Training Center, San Francisco, United States, 5University of Missouri, Columbia, United States, 6CSI Solutions, Bethesda, United States, 7Health Resources and Services Administration HIV/AIDS Bureau, Rockville, United States
Background: Unfortunately, health care organizations often tend to establish 'silos' based on funding streams and specific concerns of their constituents. Interactions among providers to jointly improve HIV care and address issues of care coordination are often limited. The National Quality Center (NQC) was established through funding by the United States (US) Government to work towards aligning quality improvement (QI) activities across HIV providers and governmental funders.
Methods: To create peer learning opportunities, NQC established national collaboratives by bringing local HIV providers and city and state governments together to achieve joint improvement goals. The Cross-Part Collaborative, spanning 5 high HIV prevalence US states, strengthened statewide collaboration, created common performance measures, and launched statewide QI projects. Participating HIV providers reached 19% of individuals living with HIV in the US. The ability of participants to report their performance data every 2 months increased from 54% to 94% over 12 months, resulting in submissions of 45,000 medical records.
Results: Results indicate an increase in CD4 monitoring (from 61% to 69%), patients on HAART (from 61% to 75%) and PCP prophylaxis (from 54% to 61%). With the success of this national initiative, NQC replicated this model and launched a collaborative in the Washington, DC metropolitan area in 2011, which includes providers that operate in several states and territories. So far, notable improvements have been made in PCP prophylaxis, increasing from 59% to 91% in the most recent data reporting cycle.
Conclusions: Regional HIV providers have benefited from the alignment of performance measures and joint QI projects. A critical component has been the integration of city and state health departments when working with local providers. The further expansion of this innovative collaboration, the first of its kind, to other states and regions is recommended. A guide to highlight common approaches and best practices is currently being published.
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