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Rapid Fire Presentation

Rapid Fire Presentation. Victoria Inner City HIV QI Network January 30 th , 2013. QI Team/Network. Cool Aid Community Health Centre Assertive Community Treatment Teams Street Nursing Program

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Rapid Fire Presentation

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  1. Rapid Fire Presentation Victoria Inner City HIV QI Network January 30th, 2013

  2. QI Team/Network • Cool Aid Community Health Centre • Assertive Community Treatment Teams • Street Nursing Program • We represent two separate programs within Vancouver Island Health Authority, and a Non-profit Community Health Centre. Working together to provide low barrier access to health services and outreach to vulnerable individuals in our community. • We have 190 registeredHIV positive patients.

  3. Changes:*by leveraging data and use of narrative* • Added another paid team member to assist in outreach, data collection, and case management • Established enhanced service provision by the Street Nurses by advocating for them to provide phlebotomy as part of their care

  4. Description of Changes*how data and narrative supported* Data and narrative has helped to identify gaps in service: • Sites where outreach services such as “seek and test” activities should be provided • Enhanced access to phlebotomy • Recalling of patients for routine HIV care, or patients lost to care • Identify MOGE patients • Further refine our knowledge of our active HIV population at Cool Aid, and/or receiving services from Street Nursing or ACT. • Further delineate who our “population of focus” is.

  5. Description of Changes “seek and test” • Enhanced outreach to provide point of care testing to several sites: • Methadone clinic, Rock Bay Landing Shelter, Our Place Society, Victoria Native Friendship Centre • POC tests done 2010 – 2012 • 2010 – 150 tests • 2011 – 170 tests • 2012 – 300 tests

  6. Description of Changes“enhanced recall” • Increase time devoted to recall of patients lost to care, & • Identification of MOGE patients • Further refine our knowledge of who our active HIV patients are • Further delineate our population of focus, and strategies to engage or reach the POF

  7. Description of Changes“increased access to phlebotomy” • Phlebotomy provision by Street Nursing Program • Previously did not have the mandate to perform blood work/phlebotomy (although have the scope) • Issue reviewed with medical director, and now fully supported to draw routine blood work for HIV patients, thus increasing access to care

  8. Description of Changes*more hours devoted to QI work* • The success of adding another team member became apparent • Identify MOGE patients • Assist with patient call-back • Increase outreach (POC testing) • See Data Next Slide

  9. Description of Changes • Registered HIV patients: • Jan 2012 = 221 • Jan 2013 = 190 • Number of HIV patients who had a pVL in last 4 months: • Jan 2012 = 132 (60%) • Jan 2013 = 152 (81%) • Number of patients taking ART in unequivocal need: • Jan 2013 = 154 (97%) • Number of patients not taking ART in unequivocal need: • Jan 2013 = 4 (3%) • Number of HIV patients who had at least 1 primary care visit in last 4 months • Jan 2012 = 171 (77%) • Jan 2013 = 153 (81%)

  10. Key Challenges and Lessons • Working “off the side of our desks” without ongoing secure resources to pay individuals. Donated funds are soon going to run out, however, leaving us to do the QI work “off the sides of our desks” again. (The Victoria HIV/AIDS QI Improvement network did not receive funding from the STOP HIV Collaborative) • Maximize scope of clinicians, enhance outreach, and maximize communication strategies • Time and funding required to do high quality comprehensive work • Need to include more reporting measures: # of patients in unequivocal need of ART, # of patients in unequivocal need who are not receiving ART, achievement of virologic control, CD4 count data

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