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in+care CampaignUpdate for QAC
September 13, 2012
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This in+care Campaign is designed to facilitate local, regional and state-level efforts to retain more HIV patients in care and to prevent HIV patients falling out of care while building and sustaining a community of learners among Ryan White providers.
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CampaignParticipation
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Nationally:474 HIV providers representing
401 HIV programs in 241 cities and across 46 States/Territories
have joined the Campaign so far
In NYS:47 HIV providers representing
40 HIV programs in 14 cities
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caring for 425,444 people living with HIV
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Updated August 27, 2012
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Campaign Components
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Campaign Components: Retention Data Submissions
• Performance Measurement• Submission of retention data every other month• 230 (57%) national participants have submitted• 22 (55%) NYS participants in have submitted
• Quality Improvement Projects• Monthly submission of Improvement Updates• 102 (25%) national participants have submitted• 10 (25%) NYS participants have submitted
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Campaign Components: Quality Coaching
• Each participating site is assigned a Quality Coach• Provide feedback on all submissions including
retention data and improvement updates• Available to answer questions related to data
analysis and improvement project design
• NYS Coaches• Nanette Brey-Magnani (Western NY)• Johanna Buck (Central and Downstate NY)• 17 (43%) sites receive active coaching, 23 (57%)
sites have not taken advantage of coaching
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Campaign Components: Webinar Curriculum
• Curriculum driven by enrollee demand / TA requests• Recorded versions of webinars saved on website• General Webinars (monthly)
• Includes national analyses of recent data• Topics include full range of institutional and social barriers to
patient retention in care and feature peer success stories• 9 programs held to date
• Meet the Author Journal Clubs (every other month)• Nationally renowned experts cover recent retention research• 5 programs held to date
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Campaign Components: Local Quality Champions
• Volunteer role for Campaign participants• Create Local Retention Group Meetings• Establish a local community of learners • NQC provides resources to support Local Quality
Champions and Local Retention Groups
• 44 Local Quality Champions• 25 Local Retention Groups formed among them• Cover 33% of US territory and 70% of Campaign
enrollees
• NYS has three Local Retention Groups• Western NY (Anthony Jordan HC – Shawntrell Miles)• Central NY (Albany Medical College – Sootyeon Kwon)• Downstate NY (Bellevue Hospital – Jennifer Carmona)
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Campaign Components: Partners in+care
• Consumer (and allies) track• Seeks to engage up to 1,000 consumers• Dedicated area of homepage contains special
resources and a toolbox for Partners in+care• Seeks to align consumer needs and input into broader
quality management dialogue on retention nationwide
• Custom Webinars• Content driven by enrollee demand (Facebook)• 4 programs to date
• Consumer Discussion Forums• Private Facebook Group (500 participants)• Listserv Group (160 participants)
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Campaign Performance and
Submitted Improvement
Strategies
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Snapshot Comparison – National and NYS Data
Campaign Data as of 09/10/2012
Dataset Dec Average
Dec Patients (Sites)
Feb Average
Feb Patients (Sites)
Apr Average
Apr Patients (Sites)
Jun Average
Jun Patients (Sites)
Aug Average
Aug Patients (Sites)
Measure 1: Gap Measure National 16.06% 123,498
(202) 16.25% 127,955 (195) 14.78% 125,661
(198) 15.30% 109,721 (174) 14.35% 100,773
(152)
NYS 11.74% 13,306 (19) 11.97% 13,288 (17) 11.78% 14,596 (17) 15.29% 14,464 (15) 10.85% 12.926 (13)
Measure 2: Visit Frequency Measure
National 64.12% 84,703 (153) 65.28% 85,336
(150) 61.77% 100,493 (172) 63.78% 88,589
(161) 63.76% 84,340 (145)
NYS 70.73% 7,998 (15) 69.93% 8,210
(13) 69.09% 8,417 71.21% 10,067 (13) 76.29% 8,879 (12)
Measure 3: New Patient Measure
National 56.92% 7,932 (192) 58.17% 8,736 (186) 58.69% 8,261 (189) 59.19% 6,939 (171) 59.81% 6,447 (152)
NYS 74.85% 843 (18) 75.41% 1,269
(16) 70.05% 1,035 (15) 67.58% 1,027
(14) 66.25% 877 (13)
Measure 4: Viral Suppression Measure
National 69.20% 133,916 (194) 69.40% 145,063
(187) 70.41% 148,975 (191) 71.81% 132,292
(174) 72.30% 118,711 (152)
NYS 67.18% 13,519 (20) 71.33% 12,740 (17) 71.85% 13,869 (17) 71.60% 13,400 (15) 75.31% 12,042 (13)
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Measure 1 – Gap Measure
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Measure 2 – Visit Frequency Measure
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Measure 3 – New Patients Measure
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Measure 4 – Viral Suppression Measure
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NYS Improvement Update Submission Review
Interventions• Data Management and Sharing/Reporting
• Track no-shows• Track patients due for visit who have not come in yet• Record potential barriers to retention in EMR for each
patient
• Patient Contact• Reminder calls (what frequency, on what timeline?)• Immediate no-show/follow-up calls (on what timeline?)• Letters to patients who have not had a visit recently
• Patient Access• Travel tokens/passes/cards/vouchers (how many units?)• Co-location of services (how thing to stretch ourselves?)
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NYS Improvement Update Submission Review
Interventions (continued)• Wrap-around Service Offerings
• Provide peer support opportunities for mental ill and substance users
• Treatment adherence counseling as part of each visit• Intensive care coordination services offered to high risk
individuals• Patient navigation services
• Patient Perks / Incentives• Patient greeters/concierges/registrars for patients to feel
important• Having food available for people to eat in waiting rooms• Distributing fast food coupons and other food cards• Child care services
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NYS Improvement Update Submission Review
Lessons Learned• Appointment Keeping Behaviors
• Schedule for when patient says “yes, definitely” (not “will try to make it!”)
• Data Management• Record reasons why each patient misses visits and analyze
aggregates• Understanding your patient demographics
• Operational Management• Flow-sheets help the team to understand patient experience and
opportunities for process/procedural improvement
• Patient Comprehension• Established care teams help patients feel at home and they will
know whom to contact with questions or when in distress
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NYS Improvement Update Submission Review
Lessons Learned (continued)• Team Efforts
• Engage all staff in discussing improvement• Engage consumer focus groups (CABs) to discuss
improvement• Discuss retention among provider agencies within
the community
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Time for Questions and Answers
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• Campaign Office Hours:Mondays & Wednesdays 4pm-5pm ET
• Improvement Update Submission Deadline: September 17, 2012, 5pm PT
• Next Partners in+care: Reaching Out to Keep Our Friends in Care September 18, 2012, 4pm ET
• Next Meet the Author: IAPAC Retention GuidelinesSeptember 19, 2012, 2pm ET
• Campaign Webinar: Identifying Patients at Risk for Falling Out of Care September 25, 2012 3pm ET
• Data Collection Submission Deadline:October 1, 2012, 5pm PT
Upcoming Events and Deadlines – Join Us!
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Campaign Headquarters:National Quality Center (NQC)90 Church Street, 13th floorNew York, NY 10007Phone 212-417-4730incare@NationalQualityCenter.org
incareCampaign.orgyoutube.com/incareCampaign