"The National Quality Center, in conjunction with HRSA HIV/AIDS Bureau, provides no-cost, state-of the-art technical assistance for all Ryan White HIV/AIDS Treatment Modernization Act of 2006 funded grantees to improve the quality of HIV care nationwide."

HIV has changed the landscape of medicine, public health, and health care in the United States since the first widely distributed reports of the disease were released in 1981. [1] The impact of the introduction of highly active antiretroviral therapy (HAART) in the mid 1990s was dramatic—the number of deaths from AIDS dropped significantly and the number of new annual AIDS diagnoses dropped over 30% between 1981 and 2004. [2][3] Although HIV-related morbidity and mortality have dropped dramatically, reductions are unevenly distributed across HIV-infected populations due to unequal access to care and variations in the quality of services provided. [4][5]

In 1990, Congress enacted the Ryan White CARE (Comprehensive AIDS Resources Emergency) Act, most recently re-authorized as the Ryan White Treatment Modernization Act of 2006 (Ryan White Program), to provide safety net funds for health and supportive services for people living with HIV/AIDS (PLWH) who have either no or inadequate insurance. This Program is administered by the Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB). 

Since 2000, the Ryan White Program legislation has included specific provisions directing federally funded grantees to establish, implement, and sustain quality management programs. These programs include the monitoring of access to and quality of health services to ensure that PLWH who are eligible for treatment receive it.  This particular focus reflects several national trends in quality management and accountability. [6][7]

Quality of care is defined by the Institute of Medicine as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with professional knowledge.”[8] Gaps in care still exist and many providers face barriers when trying to deliver high quality care to every patient, every time. Many Ryan White Program-funded grantees lack the knowledge, expertise, and resources needed to craft effective quality management programs that are linked to improved health outcomes. HIV/AIDS care providers know how challenging it is to start and sustain a quality management program when time, money, and staff are stretched to the limit, especially when trying to meet internal and external quality expectations.

Help is available. The National Quality Center has been created with the needs of busy HIV providers in mind. Since its inception in 2004, the National Quality Center (NQC) has provided leadership and support in quality improvement for Ryan White Program-funded grantees nationwide. Funded through a cooperative agreement by the HRSA HIV/AIDS Bureau with the New York State Department of Health AIDS Institute, NQC was founded to nationally meet the needs of Ryan White Program grantees, across all Parts and funded providers, for technical assistance in quality improvement.

The aim of this initiative is to build the capacity to improve the quality of HIV/AIDS care and services across the United States and its territories. NQC provides support and assistance that enable grantees to respond to and to implement quality management legislative mandates. Think of the National Quality Center as a personal quality improvement expert, a hands-on assistant that will help advance quality management programs, provide access to a central repository of key quality improvement resources, and help connect HIV providers across the country. NQC can give the support needed to improve the care and services provided to individuals with HIV/AIDS.

NQC provides a myriad of quality improvement services built around the core needs of HIV providers, including:

•          Sharing: Rapid dissemination of information and resources related to quality improvement through websites, conference exhibits, listserv activities, and direct mail

•          Training: Training and educational fora on a wide array of quality-related topics through conference calls, webcasts, educational workshops, an online training program and training-of-trainers programs

•          Consulting: Intensive, individualized, on-site and off-site consultation involving online and/or phone consultations by quality improvement experts

Over the last years, NQC has become the premiere quality improvement technical assistance resource in HIV care and has delivered national leadership in the development and administration of effective state-of-the-art HIV-related quality improvement services.

Together, we can improve HIV/AIDS care.

To request technical assistance and/or quality improvement resources, contact NQC at Info@NationalQualityCenter.org.

National Quality Center (NQC)
New York State Department of Health
90 Church Street, 13th Floor
New York, NY 10007-2919

Phone: (212) 417-4730
Fax: (212) 417-4684
General Email: Info@NationalQualityCenter.org

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[1] CDC (Centers for Disease Control and Prevention). 1981. Pneumocystiis pneumonia—Los Angeles. MMWR 30(21):1–3

[2] CDC. 2006.Epidemiology of HIV/AIDS 1981 - 2005 – Morbidity and Mortality Weekly Report, 2006 June 2, 2006 Edition. 13(2). Atlanta, GA: CDC.

[3] García de Olalla, Patricia, Knobel, Hernando, Carmona, Alexia, Guelar, AnaL. López-Colomés, José, and A. Caylà, Joan. Impact of Adherence and Highly Active Antiretroviral Therapy on Survival in HIV-Infected Patients. JAIDS Journal of Acquired Immune Deficiency Syndromes:Volume 30(1)1 May 2002pp 105-110.

[4] HRSA Care Action. Mitigating Health Disparities through Cultural Competency. http://hab.hrsa.gov/publications/august2002.htm.

[5] Smedley BD, Stith AY, Nelson AR (eds.). Unequal treatment: Confronting racial and ethnic disparities in health care. Washington D.C: The National Academies Press, 2002.

[6] Institute Of Medicine. 2000. To Err Is Human: Building a Safer Health System. Washington, DC: National Academy Press.

[7] Institute Of Medicine. 2001. Envisioning the National Health Care Quality Report. Hurtado MP, Swift EK, Corrigan JM, Eds. Washington, DC: National Academy Press.

[8] Institute of Medicine. Medicare: A Strategy for Quality Assurance. Vol. 1. (1990).