Gaining Agency and Subcontractor Buy in for Quality Management: Examples from the New York State HIV Quality of Care Program

Dan Belanger NYS HIV QOC Program Director AIDS Institute 1

NYS Quality of Care Program Highlights

 NYS Quality of Care Infrastructure  New York State Quality of Care Standards  Organizational Assessments  NYS Performance Data/e-HIVQUAL  Learning Networks  QI Technical Assistance  NYS Quality Awards 2

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New York State Quality of Care Program Overview

HIV Quality of Care Clinical Advisory Committee    Engagement of providers, QI experts and consumers across the state Advises on development, implementation and refinement of the NYS HIV QM program Building partnerships and trust since they are part of the process Consumer Advisory Committees    Address topics to improve the quality of HIV care in NYS CAC - comprised of adult consumers across NYS; provider representation from the Clinical Advisory Committee (meet quarterly) YACAC - comprised of adolescent consumers across NYS (meet twice a year) Internal Quality of Care Workgroup    Representatives from various departments in the AIDS Institute to coordinate the statewide quality of care program Review past and upcoming QI activities Meet monthly for 3 hours 3

New York State Quality of Care Program Standards

   Clearly written quality standards that are applicable to all HIV programs in NYS, regardless of caseload, location or service delivery model  Includes the following domains: Infrastructure, Performance Measurement, Improvement activity, Staff Involvement, and Consumer Involvement Standards include descriptions for each standard to explain their applicability in HIV programs  Use of ‘simple’ language Same standards are incorporated in all contracts, including Medicaid agreements  Standardization of expectations across programs 4

Annual Performance Measurement Review

   184 HIV programs in NYS (beyond Part B funding) annually self report key HIVQUAL indicators based on indicators that are developed with input from the Quality Advisory and Consumer Advisory Committees Programs use eHIVQUAL, an online application developed by the NYS to report their data; reports are validated by external agency   Data reports are instantaneously available in the application Benchmarking reports are made available Providers are expected to use the results of the review to perform quality improvement activities as needed  Each program needs to submit follow-up activities 5

Annual Organizational Assessments

     Based on the AIDS Institute quality program standards, organizational assessment tools have been developed Each of the 184 HIV programs in NYS is visited by a QOC staff/consultant to conduct an on-site Organizational Assessment to determine a sustainable QM infrastructure is in place; these activities are in addition to ongoing contract monitoring visits and performance data reviews Detailed findings and next steps are shared with CEO, medical director and program staff Findings from these assessments are discussed with contract managers for follow-up and detailed discussion about technical assistance needs If necessary, programs are offered technical assistance by QI expert 6

Technical Assistance (TA) Offerings

     On-site technical assistance by QI expert based on agreed TA objectives Technical Assistance Monthly Reports to share progress with stakeholders Monthly QI workshops based on identified needs (QI 101 and more advanced topics) Peer learning opportunities between HIV programs Tracking of TA offerings by HIV program 7

Learning Networks

   Learning Networks, modeled after the IHI Breakthrough Series, combine ongoing on-site consultation with structured one day/half-day group meetings that focus on quality management Provide a forum for peer learning which enables teams to exchange ideas through the network’s activities   Joint QI projects within network Sharing of successes/challenges Learning networks currently underway include   3 HHC Networks, Substance Use Network, Adolescent Network, Upstate Network, Part C/D Network harm reduction services, food and nutrition, treatment adherence support, mental health, case management and medical case management 8

Annual Quality of Care Awards

 Annual NYS QOC Program Awards in the following categories:  Excellence in Quality Performance  Senior Leadership on Quality Improvement  Achievement in Quality Improvement NYSDOH  Consumer Involvement In Quality Improvement  Nomination/Application process with review by the Internal Workgroup 9

Annual Awards Ceremony

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And….

Thank you!

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Contact Information

Dan Belanger NYS HIV QOC Program Director AIDS Institute/New York State Department of Health Phone: (212) 417-5131 Email: [email protected]

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