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Measuring Our Collaborative Progress:  Linkage and Retention in Upper Manhattan Denis Nash, PhD, MPH Diane Addison, MIA,

Measuring Our Collaborative Progress:  Linkage and Retention in Upper Manhattan Denis Nash, PhD, MPH Diane Addison, MIA, MPH CUNY School of Public Health. UMRG 3 rd Learning Session: July 19th, 2012. Outline of presentation. Overview of NY Links Collaborative Measures

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Measuring Our Collaborative Progress:  Linkage and Retention in Upper Manhattan Denis Nash, PhD, MPH Diane Addison, MIA,

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  1. Measuring Our Collaborative Progress:  Linkage and Retention in Upper ManhattanDenis Nash, PhD, MPHDiane Addison, MIA, MPHCUNY School of Public Health UMRG 3rd Learning Session: July 19th, 2012

  2. Outline of presentation • Overview of NY Links Collaborative Measures • Analysis of NY Links Collaborative data results for the Upper Manhattan Regional Group • Using data to measure the effectiveness of improvement strategies (examples from the field)

  3. NY Links Collaborative Measures Purpose of NY Links Collaborative Measures: • For each team - to assess and support its internal linkage and retention efforts and bench-mark its performance with providers in the region and • To measure the progress and impact of our collaborative efforts to improve linkage to and retention in HIV clinical care • Frequency of reporting by sites: Every 2 months • Submission dates: April 2, June 1, August 1, October 1, etc…

  4. Upper Manhattan Regional Group (UMRG) site map and types of services provided Map: Blue dots indicate clinical sites and yellow dots indicate supportive service and testing sites. Data Source: Baseline site survey, updated: June 15, 2012

  5. Brief Overview of NY Links Collaborative Measures

  6. % of UMRG sites reporting on collaborative measures Total number of participating UMRG sites: 25 Data Source: NY Links collaborative measures—through June 2012 submission, updated: July 11, 2012

  7. Measuring Our Collaborative Progress

  8. Data AnalysisQuestions to Keep In Mind What are our major findings . . . What is the frequency of patients not getting linked to and/or retained in care? Is this what you would expect? What is the impact of not being linked/retained in care? What is the feasibility that we can improve this?

  9. UMRG: proportion of newly diagnosed clients linked to care within 30 days 82 clients 17/22 sites 95 clients 14/22 sites Data Source: NY Links collaborative measures, updated: July 11, 2012

  10. UMRG: proportion of patients retained in care 6,633 patients 12/17 sites 5,975 patients 11/17 sites Data Source: NY Links collaborative measures, updated: July 11, 2012

  11. UMRG: proportion of new patients retained in care 872 patients 12/17 sites 757 patients 12/17 sites Data Source: NY Links collaborative measures, updated: July 11, 2012

  12. UMRG: proportion of clients engaged in care 815 clients 9/17 sites 629 clients 8/17 sites Data Source: NY Links collaborative measures, updated: July 11, 2012

  13. UMRG: proportion of new clients engaged in care 58 clients 11/17 sites 64 patients 10/17 sites Engaged: number of new clients/patients in the reporting period, without a documented HIV clinical care provider or visit upon enrollment, who had at least one medical visit with a provider with prescribing privileges within 30 days of enrollment in the supportive service program Data Source: NY Links collaborative measures, updated: July 11, 2012

  14. UMRG summary of collaborative measures: percentage linked, retained or engaged in care, data through June 2012 % linked, retained, or engaged Data Source: NY Links collaborative measures, updated: July 11, 2012

  15. Measuring the effectiveness of interventionsExamples from the field

  16. Improving enrollment of HIV patients in care using continuous quality improvement, Uganda USAID Health Care improvement Project, “Improving coverage, retention and clinical outcomes of HIV patients in Uganda using continuous quality improvement”, February 2012.

  17. Reducing missed appointments and number of lost clients through community tracking using peer clients and zoning to ease follow-up: Pallisa District, Eastern Uganda Intervention Intervention USAID Health Care improvement Project: “Reducing missed appointments and number of lost clients through community tracking using PHAS and zoning to ease follow-up”, Rotich Leonard, 2012

  18. Comparing outcomes for different linkage and retention strategies in HIV care, example * * * * * p<0.05; adjusted for facility type, urban/rural, year clinic began ART services, and patient load M Lamb et al. PLoS One, 2012

  19. Patient navigator intervention to increase screening colonoscopy, Lincoln Hospital Nash et al. J Urban Health, 2006

  20. Patient navigator intervention to increase screening colonoscopy, Lincoln Hospital Nash et al. J Urban Health, 2006

  21. Patient navigator intervention to increase screening colonoscopy, Lincoln Hospital Nash et al. J Urban Health, 2006

  22. Next Steps • Share data with your team/agency: - How does your linkage and retention performance compare with the collaborative? - How can/will your improvement efforts contribute the overall collaborative outcome? • Intervention strategy Tracking Tool • Sign up for check in-call through doodle • Intervention Strategy Tracking Tool completed online • Next submission due date: August 1, 2012

  23. Thoughts/questions/comments on NY Links Evaluation? Denis Nash (dnash@hunter.cuny.edu) Diane Addison (daddison@hunter.cuny.edu)

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