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in + care Campaign Webinar December 7, 2011

in + care Campaign Webinar December 7, 2011. Ground Rules for Webinar Participation. Actively participate and write your questions into the chat area during the presentation(s) Do not put us on hold Mute your line if you are not speaking (press *6, to unmute your line press #6)

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in + care Campaign Webinar December 7, 2011

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  1. in+care CampaignWebinar December 7, 2011

  2. Ground Rules for Webinar Participation Actively participate and write your questions into the chat area during the presentation(s) Do not put us on hold Mute your line if you are not speaking (press *6, to unmute your line press #6) Slides and other resources are available on our website at incareCampaign.org All webinars are being recorded

  3. Agenda • Welcome & Introductions, 5min • Stories from the Field, 10min • Data Integrity Maintenance, 15min • Review of December Campaign Data, 15min • Stories from the Field, 10min • Q & A Session, 5min

  4. Project CONNECT James Raper, DSN, CRNP, JD, FAANP, FAAN Associate Professor of Medicine & Nursing University of Alabama at Birmingham

  5. UAB 1917 Clinic: Linkage to care Problem identified: Scheduled new patient visits often not attended (“no show”) Study of patients calling to establish HIV care at UAB 1917 Clinic, 2004-2006 31% of patients (160 of 522) failed to attend a clinic visit within 6 mos. of initial call Mugavero et al. Clin Infect Dis 2007;45:127-130

  6. Project CONNECT Program launched January 1, 2007 New patients have orientation visit within 5 days of their initial call to the clinic Semi-structured interview, psychosocial questionnaires & baseline labs Uninsured patients meet with clinic SW Prophylactic antibiotics initiated more quickly Expedited referral for SA / MH services Interview Predisposing factors: Education, Income Enabling factors: Insurance, Transportation, Housing, Social support, Spirituality, Stigma Contextual factors: Dependant care, Recent incarceration, Intimate partner violence Perceived barriers to HIV care

  7. CONNECT: Program Evaluation aMultivariable model controls for age, race, sex, insurance, location of residence and time from call to scheduled visit.

  8. Data Integrity Maintenance Anne Rhodes Services Analyst, HIV Care Services Virginia Department of Health Terri Fox, MSW Research Analyst Rutgers University, School of Social Work

  9. Anne RhodesServices Analyst, HIV Care ServicesVirginia Department of Health

  10. Quality Management Tools

  11. Barriers to Use

  12. Measures

  13. Retention Global Issues

  14. Current Retention Measure: 2 or more visits at least 3 months apart * Source: Virginia Client Reporting System (VACRS)

  15. Current Work in Virginia • Discussion with DIS and CBOs funded for testing to set up consent process • Programming all retention measures into VACRS • Matching with state surveillance/ obtain other sources of care markers (Medicaid, Medicare, labs)

  16. Terri Fox, MSW Research Analyst Rutgers University, School of Social Work

  17. NJ Data Integrity Maintenance • Make the data a priority by using it • Infuse data expectations in contract language, regular reporting, and outcome evaluation • Work with a diverse group of staff/providers/consumers (depending on your ‘program’ unit) to ensure common understanding of definitions of services, units and realistic outcomes • Get the input from all parties involved about what goals for service should be • Commit to working towards the stated goals

  18. NJ Data Integrity Maintenance 6. Ensure that the scope isn’t too broad; the focus and amount of data should be narrow—(what do we fix first? ); where there are too many variables, each one gets a little lost to someone, diluting the potential for impact 7. When there is a question of the integrity of the data, there MUST be a follow up to address the data issue. Do NOT accept ‘there is a problem with the data’ as the end of the discussion. Next steps should always be to address said ‘data’ problem

  19. NJ Data Integrity Maintenance 8. Identify data champions at each site; a data champion understands the local service system and how service information is translated into data points in whatever software/form/chart that you are using 9. Include the data champions in any and all discussions about data, especially where the program manager may not be as data savvy as the nurse, case manager, etc. 10. Check the data on a regular basis- does it look like the levels of service are being met- how are the outcome variables? What is the quality of care as expressed by the data?

  20. NJ Data Integrity Maintenance 11. Train annually. This never hurts anyone. You can even let your champions participate in training new/newer staff 12. Do NOT make data entry overly complicated. There should be no translation/interpretation needed from contact sheet to database 13. Make realistic goals for care. Do not set providers up to fail. (Meet providers where they are- take steps towards achievable goals) 14. Communicate that data are part of care; not an addition to care

  21. Review of December Campaign Data Michael Hager, MPH MA NQC Manager

  22. Data Review – Measure 1: Gap Data Points: • 85 organizations submitted data • 54,256 patients in sample Data Results: • 16.16% patients experienced gap in care • Top 10%: 2.85%; Top 25%: 4.60%

  23. Data Review – Measure 2: Visit Frequency Data Points: • 59 organizations submitted data • 34,508 patients in sample Data Results: • 60.43% patients retained in care for 2 yrs • Top 10%: 88.60%; Top 25%: 85.93%

  24. Data Review – Measure 3: New Patients Data Points: • 76 organizations submitted data • 5,021 patients in sample Data Results: • 61.5% new patients retained in care for yr • Top 10%: 99.98%; Top 25%: 89.96%

  25. Data Review – Measure 4: Viral Suppression Data Points: • 77 organizations submitted data • 56,094 patients in sample Data Results: • 70.33% patients virally suppressed at last viral load test • Top 10%: 86.90%; Top 25%: 82.58%

  26. December Campaign Data • What have you learned?

  27. Retention and Viral Suppression Theresa Rubin, MA, MPhil Quality Coordinator, AIDS Care Unit North Carolina Department of Health & Human Services [Theresa.rubin@dhhs.nc.gov]

  28. Looking at Viral Load • NC has 95 counties in Part B Program • 8,201 Part B Clients for April 1, 2010 to March 31, 2011 • All subgrantees and their contractors required to use CAREWare • Viral Load data are for all HIV+ clients • 91% had at least 1 Viral Load test • Suppression was defined as VL ≤ 100 • We will be using VL ≤ 200 for the future

  29. Time for Questions and Answers

  30. Introducing Campaign Office Hours • Purpose: directly communicate with NQC staff and consultants • ask general questions • request technical assistance • engage in dialogue about the Campaign. • Details: Mondays and Wednesdays from 4pm-5pm ET • Conference Call #: 866-394-2346 • Participant Code #: 4182576142#

  31. Next Steps • First Data Collection Submission Deadline: December 15, 2011 (Deadline Extended) • First Improvement Update Submission Deadline: December 15, 2011 • Office Hours: December 7/12/14/19/21 4pm-5pm ET • January Webinar: TBA • Meet the Author – Dr. Thomas Giordano: January 12, 2012 at 12pm ET

  32. Campaign Headquarters:National Quality Center (NQC)90 Church Street, 13th floor New York, NY 10007Phone 212-417-4730 incare@NationalQualityCenter.orgincareCampaign.org youtube.com/incareCampaign

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