When HIV providers work in partnership, they have the potential to strengthen their individual quality management programs as well as the overall quality of HIV care in their region. The HIV Cross-Part Care Continuum Collaborative (H4C) is designed to build regional capacity for linkage to and retention in care. The goal is to ultimately improve viral load suppression, align quality management goals with Ryan White legislative mandates, and seamlessly coordinate HIV services across Program Parts.
The H4C Collaborative aims to:
- Maximize the use of available data, increase the availability of local HIV Care Continuums, and teach providers how to use performance data effectively to improve care
- Foster active regional collaboration
- Initiate a local quality improvement project on viral suppression across all regional grantees
- Advance quality management competencies by coordinated quality improvement training activities
- Strengthen consumer involvement in quality activities to improve HIV care
- Create sustainable quality improvement infrastructure across the collaborative region to maintain the regional momentum of the Collaborative
Overview of the H4C Collaborative:
- 5 states are participating, including: Arkansas, Mississippi, Missouri, New Jersey, and Ohio
- Face-to-face learning sessions are held to facilitate peer sharing and capacity building
- A statewide quality improvement project is initiated to focus on viral load suppression or retention
- A statewide HIV Care Continuum is developed to maximize use of regional data by HIV providers
- A state-wide quality management plan is developed and describes the quality management infrastructure
- There is bimonthly data reporting on the HIV/AIDS Core Clinical Performance Measures for Adults and Adolescents, stratified by three disparity categories (e.g., gender, age, race/ethnicity)
- Local quality-improvement capacity-building trainings are offered to HIV providers and at least one annual quality improvement training is offered to consumers
Map of H4C participating states.
To learn more about H4C activities and its progress | NationalQualityCenter.org/nqc-activities/collaboratives/h4c-collaborative//
For the first time, we sought to assess the impact of NQC services on Ryan White grantees and ultimately, on health outcomes. In a report, created in collaboration with John Snow, Inc. Research and Training Institute, we demonstrated the effectiveness of our services, indicating its accountability for the significant federal funds invested and the need for sustainability and further investment.
The study found that NQC has been highly successful at reaching Ryan White grantees and delivering important quality improvement-related services. More than 88% of all Ryan White grantees have utilized one of our quality improvement services.
Chart of participation in key NQC services by funding Part.
NQC also measurably improved the quality improvement capacity among Ryan White grantees. This has resulted in demonstrable advancements in grantee quality management programs and in meeting Ryan White legislative requirements. For example,
- Regional Group members showed stronger quality management programs than non- Regional Group members, and active participation resulted in more robust local quality managementprograms
- NQC Collaboratives successfully brought together grantees across states or regions to work on quality improvement activities, create peer-learning opportunities, improve performance measurement, and create a regional quality improvement leadership infrastructure
- As a result of ongoing technical assistance, organizational capacity for quality management increased along with individual quality improvement knowledge and skills
- The Part C/D Quality Improvement Initiative increased quality improvement capacity, as seen through increased organizational assessment scores
- Training participants showed increased knowledge and skills between the beginning and end of the face-to-face training
Our services have had a positive impact on the quality of HIV care and have demonstrated improved health outcomes. For example,
- Participation in Regional Groups is linked with statistically significant improvements on key performance measures, including increased viral load suppression rates
- in+care Campaign participants demonstrated statistically significant improvements in national retention and viral load suppression rates
- Both the DC and the Cross-Part Collaborative participants demonstrated significant improvements in clinical HIV performance measures
- Part C/D Initiative participants showed improvements in national retention and viral load suppression rates
Our services align Ryan White grantees quality improvement goals with National HIV/AIDS Strategy (NHAS) priorities, along with other regional and local priorities.
- The in+care Campaign was formed based on the NHAS aim of retention; the Campaign has been successful in improving clinical outcomes for retention and viral load suppression
- Regional Groups create local synergies to bring together Ryan White grantees to establish local priorities
- NQC’s work aligns the priorities of Ryan White grantees and with that of consumers; in part, through various consumer-focused initiatives
The full Impact Evaluation Report will be available soon.