The document discusses using quality improvement (QI) methods through a peer learning network called the Community Health Center Quality Learning Network (CHCQLN) to improve viral load suppression (VLS) among HIV-infected patients in New York. Over time, more clinics participated in the network and the number of unsuppressed patients receiving targeted QI interventions increased. The percentage of initially unsuppressed patients that achieved VLS after these interventions also increased. The network facilitated peer learning and data sharing between clinics. Through collaborative testing of changes tailored to their patient populations, clinics were able to improve VLS rates, though no single intervention was identified as critical. Public health departments and clinics can work together through quality improvement learning networks to achieve health goals
Evaluation of the Impact of a Social Support Strategy on Treatment OutcomesMEASURE Evaluation
Shared at a data dissemination and data use workshop on the results of the impact evaluation of the Strengthening Tuberculosis Control in Ukraine project. Access another presentation at https://www.slideshare.net/measureevaluation/evaluation-of-the-tbhiv-integration-strategy-on-treatment-outcomes.
Evaluation of the TB-HIV Integration Strategy on Treatment OutcomesMEASURE Evaluation
Shared at a data dissemination and data use workshop on the results of the impact evaluation of the Strengthening Tuberculosis Control in Ukraine project. Access another presentation at https://www.slideshare.net/measureevaluation/evaluation-of-the-impact-of-a-social-support-strategy-on-treatment-outcomes/.
This presentation summarizes the results of a June 2021 survey of veterinary professionals on the effects of the COVID-19 pandemic on veterinary practices and heartworm management
This resource summarizes the eight recommendations outlined in the Institute of Medicine's a new consensus study entitled, Improving Diagnosis in Health Care. The recommendations are aimed at making diagnoses more accurate, reliable, efficient, and safe. This work is a continuation of the IOM’s Quality Chasm series.
Evaluation of the Impact of a Social Support Strategy on Treatment OutcomesMEASURE Evaluation
Shared at a data dissemination and data use workshop on the results of the impact evaluation of the Strengthening Tuberculosis Control in Ukraine project. Access another presentation at https://www.slideshare.net/measureevaluation/evaluation-of-the-tbhiv-integration-strategy-on-treatment-outcomes.
Evaluation of the TB-HIV Integration Strategy on Treatment OutcomesMEASURE Evaluation
Shared at a data dissemination and data use workshop on the results of the impact evaluation of the Strengthening Tuberculosis Control in Ukraine project. Access another presentation at https://www.slideshare.net/measureevaluation/evaluation-of-the-impact-of-a-social-support-strategy-on-treatment-outcomes/.
This presentation summarizes the results of a June 2021 survey of veterinary professionals on the effects of the COVID-19 pandemic on veterinary practices and heartworm management
This resource summarizes the eight recommendations outlined in the Institute of Medicine's a new consensus study entitled, Improving Diagnosis in Health Care. The recommendations are aimed at making diagnoses more accurate, reliable, efficient, and safe. This work is a continuation of the IOM’s Quality Chasm series.
Getting Investigators Onboard: Lab Preferences Make a Difference in Trial Par...Covance
Clinical trials are becoming increasingly complex and competitive, so attracting the best investigator sites to participate in a trial is a crucial step in meeting patient enrollment targets. Learn more about how investigator preference can help meet trial recruitment milestones.
Virtual knowledge network NIMHANS Echo : Innovative tele- mentoring model for skilled capacity building in addiction & mental health by Prabhat Chand , NIMHANS, India
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Decision aids can be highly-effective tools to promote shared decision making and support patients in becoming engaged participants in their healthcare. Join us for the first-ever convening with leaders behind a Washington experiment in certifying decision aids, as state officials, health systems, and on-the-ground implementation experts share lessons learned and discuss policy recommendations for national or statewide approaches to decision aid certification.
For more information, visit our website at: http://petrieflom.law.harvard.edu/events/details/decision-aids-for-patients-with-serious-illness
Purpose of the Webinar
1.Describe the process of developing an undergraduate MedRec IPE Event involving > 480 senior Medicine, Pharmacy and Nursing students;
2.Explain the logistics of conducting the event in multiple venues and urban/remote locations;
3.Discuss the successes and challenges of communicating MedRec patient safety concepts through this process; and
4.Describe future opportunities for enhancing undergraduate MedRec training in an interprofessional environment.
Watch the webinar recording: http://bit.ly/1fSqsqv
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Getting Investigators Onboard: Lab Preferences Make a Difference in Trial Par...Covance
Clinical trials are becoming increasingly complex and competitive, so attracting the best investigator sites to participate in a trial is a crucial step in meeting patient enrollment targets. Learn more about how investigator preference can help meet trial recruitment milestones.
Virtual knowledge network NIMHANS Echo : Innovative tele- mentoring model for skilled capacity building in addiction & mental health by Prabhat Chand , NIMHANS, India
April 18, 2018
Decision aids can be highly-effective tools to promote shared decision making and support patients in becoming engaged participants in their healthcare. Join us for the first-ever convening with leaders behind a Washington experiment in certifying decision aids, as state officials, health systems, and on-the-ground implementation experts share lessons learned and discuss policy recommendations for national or statewide approaches to decision aid certification.
For more information, visit our website at: http://petrieflom.law.harvard.edu/events/details/decision-aids-for-patients-with-serious-illness
Purpose of the Webinar
1.Describe the process of developing an undergraduate MedRec IPE Event involving > 480 senior Medicine, Pharmacy and Nursing students;
2.Explain the logistics of conducting the event in multiple venues and urban/remote locations;
3.Discuss the successes and challenges of communicating MedRec patient safety concepts through this process; and
4.Describe future opportunities for enhancing undergraduate MedRec training in an interprofessional environment.
Watch the webinar recording: http://bit.ly/1fSqsqv
On November 17, 2015 the ICU Collaborative Faculty held a National Call to determine the 2016 National Improvement Initiative. Two topics were presented: Dr. Yoanna Skrobik advocated on the side of Pain, Agitation and Delirium. Dr. Claudio Martin and Cathy Mawdsley advocated for working on End of Life Care. Callers voted at the end of the call and chose the new topic led by Dr. Skrobik: Managing “PAD” in your ICU patient: assessment, treatment and prevention.
Representatives from the Philadelphia Department of Public Health (PDPH) presented an update on their strategic plan for sexual health at the February 2015 meeting of the Philadelphia Ryan White Part A Planning Council.
Philadelphia Department of Public Health HIV Prevention ActivitiesOffice of HIV Planning
Coleman Terrell of the Philadelphia Department of Public Health presented on the PDPH's HIV Prevention Activities at the Philadelphia HIV Prevention Planning Group's December 2014 meeting.
OHP's Antonio Boone gave this presentation on different prevention continuum examples at the July meeting of the Prevention Committee of the Philadelphia EMA HIV Integrated Planning Council.
The intersection of opioid use and HIV is well documented. More than one-third of all AIDS cases in the U.S. are directly or indirectly linked to injection drug use. Additionally, dependence and abuse of pain relievers is on the rise; people living with HIV/AIDS who suffer from chronic pain may be at particular risk. Opioids are highly addictive and mortality among illicit opioid users is estimated at 13 times that of the general population. The SPNS Buprenorphine Initiative investigated the effectiveness of integrating buprenorphine opioid abuse treatment into HIV primary care settings.
This Webcast is the first in a series under the new SPNS Integrating HIV Innovative Practices project (www.careacttarget.org/ihip) to assist providers in replicating SPNS work in their sites. This Webcast will introduce providers to the SPNS Buprenorphine Initiative, its findings, its synergy with the National HIV/AIDS Strategy, and provide an overview of opioid use and HIV.
The subsequent Webcast in the series will examine the clinical aspects of buprenorphine therapy, best practices, and implementation guidance. See also Integrating Buprenorphine Therapy Into HIV Primary Care Settings, a monograph on best practices, available at: https://careacttarget.org/content/integrating-buprenorphine-therapy-hiv-primary-care-settings.
At the April 16th, 2016 meeting of the Philadelphia Ryan White Planning Council, Evelyn Torres and Sebastian Branca of the AIDS Activities Coordinating Office (AACO) presented their annual Client Services Unit (CSU) report.
Ueda2015 tupelo.nurses role in dm prevention dr.martyn molnar
NESS Poster final
1. Developed by Associates in Process Improvement
Using Quality Improvement (QI) Methods and Peer Learning to
Improve Viral Load Suppression among HIV-Infected Patients in
New York State
1 New York State Department of Health AIDS Institute, New York, NY
Viral load suppression (VLS) among HIV-infected
patients is critical to patient outcomes and is
fundamental to preventing the transmission of HIV.
Clinics face challenges helping patient achieve VLS
and can utilize QI to systematically provide better
support to patients.
Background
Hypothesis
The New York State Department of Health AIDS
Institute, through facilitation of peer learning, coaching
and technical assistance, can assist HIV care providers
at community health centers to build skills for analysis
of performance data to identify the root causes of VLS
interruptions, and to apply QI methods to improve VLS.
Research Design / Methods
Multidisciplinary care teams in the Community Health
Center Quality Learning Network (CHCQLN)
collaborated to improve VLS. Participants at each site
analyzed the characteristics of
all unsuppressed patients and
engaged in PDSA cycles to
test process changes tailored
to identified subgroups of
unsuppressed patients.
QI Interventions
Peer Learning
Data / Observations
The number of sites involved in CHCQLN increased
from 22 in 2014 to 25 in 2015. Clinic teams adopted
tested changes that yielded positive results. The
number of patients who received targeted QI
interventions from clinics as a result of CHCQLN
increased from 626 unsuppressed patients in 2014 to
1,253 patients in 2015. The percentage of initially
unsuppressed patients that achieved VLS (at most
recent test) increased from 42% (n=260, March 2015)
to 59% (n=1023, December 2015).
Clinics focused their interventions on patients facing the
greatest challenges achieving VLS. While patients in
identified subgroups did not become suppressed at
higher rates than other initially unsuppressed patients,
the two largest subgroups were those of patients with
mental health issues and substance use. These groups
may need different or additional interventions and more
time to observe improvement.
Results
Conclusion
Public health departments and community healthcare
centers can work collaboratively to achieve public
health goals and improve patient health outcomes
through leading and facilitating quality improvement
learning networks that promote peer exchange and use
benchmarked data. While no single intervention was
identified as critical to improving VLS rates, our data
suggest that a set of multidisciplinary changes tailored
to the needs of the patient population have an impact
on VLS outcomes.
Emily Schlussel Markovic1, Daniel Belanger1, Christopher Wells1, Jacob Lowy1, Bruce Agins1
Meetings and webinars facilitated peer learning
using the following methods:
• Structured round table discussions
• Case study presentations
• QI storyboards
• Data drill down exercises
• Flow chart and process diagrams
• Driver diagrams
• Cause and effect diagrams
0
139
283
448
1023
0
200
400
600
800
1000
1200
2011 2012 2013 2014 2015
Number of Patients that Received Targeted QI
Intervention and Received Subsequent VL Test
75%
82%
84%
81%
84%
50%
55%
60%
65%
70%
75%
80%
85%
90%
95%
100%
2011 2012 2013 2014 2015
Mean Reported Clinic-Wide VLS Rate for 8 Sites with
Continuous Participation in CHCQLN from 2012 to 2015
Average self-reported clinic VLS rate
increased 9 percentage points for
sites that have participated
Intervention Type Number of Sites
Adherence counseling/education 15
Case conferencing (with/without patient) 13
Psychosocial 7
Adherence devices 5
Outreach calls/letters 5
Care coordination 4
Lab/clinic processes 4
Appointment reminders 3
Viral load visuals 2
Incentives 2
Peer education 2
*We performed a two-tailed Wilcoxon signed-rank test using data from the 21
sites that submitted data both years. Among these sites, the average VLS rate
was 76% in 2014 and 79% in 2015 (p < 0.01).
Results 2014 2015
Number of participating sites 22 25
Average Self Reported Clinic VLS Rate* 77% 80%
Patients Engaged in QI 626 1253
Patients Receiving Subsequent VL test 448 1023
Suppressed at Last VL Test Subsequent
to QI intervention 306 605
Percent Suppressed at Last VL Test
Subsequent to QI intervention 68% 59%
Representatives from each
site met quarterly and
participated in QI exercises
that facilitated peer
exchange. Routine data
were collected, aggregated
and shared with participants.
CHCQLN Driver Diagram
Primary Outcome | Primary Drivers | Secondary Drivers
The CHCQLN Driver Diagram is one tool for helping clinics target patient level
interventions. This diagram was first developed collaboratively by network
members at a CHCQLN meeting in 2013. Since then, it has been continuously
updated to identify and act on the secondary drivers for improving VLS rates.