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Quality Management in the Philadelphia EMA

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Sebastian Branca of the AIDS Activities Coordinating Office provided this overview of AACO's quality management program to the HIV Integrated Planning Council on May 10, 2018. This presentation includes discussion of secret shoppers, quality improvement plans, and quality management initiatives.

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Quality Management in the Philadelphia EMA

  1. 1. Quality Management in the EMA Sebastian Branca Manager of Information Services, AACO May 10, 2018
  2. 2. Quality Management (QM) The QM process includes: • Quality assurance • Outcomes monitoring and evaluation • Continuous quality improvement (QI) The goal of the EMA’s QM program is to use high quality data to continually improve access to high quality clinical HIV care
  3. 3. QM and the Continuum of Care In accordance with National Goals, initiatives are being directed at all stages of the care continuum • Diagnosis and linkage • CDC-funded 18-1802 and 15-1509 • QI on prevention processes and systems • Retention and viral suppression • Quality improvement projects (QIPs) in Ryan White O/AHS and MCM • Implementation of QI on health disparities
  4. 4. The QI Process in the EMA Collect and analyze data to assess client outcomes • Local and HAB performance measures • Other available data Use data to improve client outcomes • Provider use of CAREWare reports • Ongoing feedback to providers • Benchmarking and trends • QIPs • Regional QI Meetings • Technical assistance and training with providers
  5. 5. Outcome Monitoring in the EMA Performance Measures • AACO is updating the entire portfolio of O/AHS measures for implementation this summer • MCM measures being developed for new model Access to Care • Regular “secret shopper” calls to O/AHS providers, including feedback and corrective actions Health disparities • Connected to QI to improve health equity
  6. 6. Performance Measures •26 measures for O/AHS services (about to be 23) •7 MCM measures •3 oral health measures •Measures for all other services and health equity data calculated from RW database •VL suppression •Gap in medical visits
  7. 7. Monitoring and Feedback •Strong emphasis on feedback in the EMA •Data validation offers opportunity for feedback and identification of training needs •Feedback reports • Data visualization highlights strengths and needs • Benchmarking contextualizes data • Assists in prioritizing QIPs •Feedback on QIPs helps to translate data into action intended to improve health outcomes
  8. 8. Quality Improvement Projects •O/AHS and MCM providers submit QIPs and quarterly updates each year •AACO reviews all QIPs and provides written feedback •In 2017, AACO reviewed 70 QIPs •Each year, key measures are defined and automatic thresholds are set for QIPs •2017 focus was on VL suppression, retention, cervical cancer screening, and gonorrhea screening for MSM •Programs may still select other measures for improvement in addition to required QIPs
  9. 9. Consumers and QI •AACO emphasizes consumers in the QI process •Consumers on QI teams or committees •Obtain input from Consumer Advisory Boards during key stages of a QI process •Consumer focus groups •Client surveys to obtain client input relating to causes for low performance or proposed action steps
  10. 10. QIPs Are Effective •Over the past four years, 81% (128/158) of QIPs for O/AHS have resulted in better outcomes •Average Improvement from O/AHS QIPs in 2016 • VL Suppression +2% • Cervical Cancer Screening +10% • MSM Receiving Gonorrhea Screening +29% •Average improvement in 2016: • Without QIP 1% • With QIP 15%
  11. 11. Average Improvement in Outcomes -2.0% 0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 16.0% 18.0% 2012 2013 2014 2015 2016 QIP no QIP
  12. 12. Viral Load Suppression •Philadelphia ranks 1st among all large EMAs for VL suppression (86.1%) •In 2017, 19/23 adult O/AHS programs in the EMA met the National Goal of 80% or higher VL suppression • 2 programs that did not meet the goal were between 79.5%-80.0% • 12 programs had 85% or higher VL suppression • 4 programs had 90% or higher VL suppression
  13. 13. QM Initiatives in 2018 •Implementation of updated O/AHS measures portfolio •New MCM model and measures •Development of provider QM Plans •QI on risk reduction measures, VL suppression and Hepatitis C for O/AHS •QI on retention in care, VL suppression and service care plans for MCM •Regional initiative around health disparities •Reconfiguring and streamlining EMA’s QM Plan
  14. 14. Questions or Comments

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