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in+care Campaign Kick-Off Webinar November 2, 2011 1 Laura W. Cheever, MD, ScM Chief Medical Officer, HAB Deputy Associate Administrator 2 Agenda • • • • • • • 3 Welcome & Introductions, 5min Campaign Expectations and Update, 10min Intro to Campaign Measures, 20min Data Reporting, 10min Local Quality Champions, 5min Consumer Involvement, 5min Q & A Session, 5min in+care Campaign Expectations & Update Clemens Steinbock 4 This in+care Campaign is designed to facilitate local, regional and state-level efforts to retain more HIV patients in care and to prevent HIV patients falling out of care while building and sustaining a community of learners among Ryan White providers. 5 Campaign Framework • participation in the Campaign is voluntary and Ryan White grantees across all funding streams and subgrantees are invited to join • participating agencies enroll for a 12-month commitment • routine reporting of performance data on up to 4 uniform Campaign-related measures • routine submission of a simple progress report to highlight improvement strategies and challenges 6 Campaign Framework • monthly webinars provide content expertise and promote peer sharing • routine retention journal clubs by renowned researchers to review recent publications • participating agencies have access to coaches for support • regional/local meetings of Campaign participants are held with the help of Quality Champions, where possible • content-specific affinity group webinars/Study Groups are conducted and facilitated by peer providers • consumer are involved as partners in this Campaign 7 in+care Participants by Zip Code (as per Nov 2, 2011) 8 Alaska Native Tribal Health Consortium, Anchorage, AK Fulton County Government, Atlanta, GA State of New Hampshire, Division of Public Health Services, St. George's Clinic, Birmingham, AL Fulton County Ryan White Program, Atlanta, GA Concord, NH Franklin Primary Health, Inc., Mobile, AL Georgia Department of Public Health - HIV Unit, Atlanta, GA Dartmouth Hitchcock Medical Center, Lebanon, NH Montgomery AIDS Outreach, Inc., Montgomery, AL Grady Memorial Hospital Corporation, Atlanta, GA Visiting Nurse Association, Asbury Park, NJ Whatley Health Services, Inc., Tuscaloosa, AL Georgia Health Sciences University, Augusta, GA Cooper University Hospital, Camden, NJ ARcare, Kensett, AR DeKalb County Board of Health Ryan White Early Care Clinic, Jersey City Medical Center, Jersey City, NJ Jefferson Comprehensive Care System, Inc., Pine Bluff, AR Decatur, GA Jersey Shore University Medical Center, Neptune, NJ Arizona Dept of Health Services, Phoenix, AZ AID Gwinnett, Duluth, GA Robert Wood Johnson Medical School, New Brunswick, NJ Phoenix Children's Hospital, Phoenix, AZ Cobb-Douglas Board of Health, Marietta, GA UMDNJ - RWJMS Eric B. Chandler Health Center, New El Rio Santa Cruz Neighborhood Health Center, Inc., Tucson, AZ Waikiki Health Center, Honolulu, HI Brunswick, NJ West County Health Centers, Inc., Guerneville, CA Iowa Department of Public Health, Des Moines, IA Newark Beth Israel Medical Center, Newark, NJ Mendocino Community Health Clinic, Inc., Lakeport, CA University of Iowa, Iowa City, IA Saint Michael's Medical Center, Peter Ho Memorial Clinic, Newark, AltaMed Health Services, Los Angeles, CA Siouxland Community Health Care, Sioux City, IA NJ Charles Drew University of Medicine and Science, Los Angeles, CA Alliance of Chicago, Chicago, IL The FXB Center, Newark, NJ Los Angeles Gay & Lesbian Center, Los Angeles, CA Chicago Department of Public Health, Chicago, IL UMDNJ Newark - ID Clinic, Newark, NJ University of Southern California/Maternal, Child & Adolescent Howard Brown Health Center, Chicago, IL St. Joseph's Hospital & Medical Center, Paterson, NJ Health Program, Los Angeles, CA Indiana University Health-LifeCare, Indianapolis, IN Health Division - Ryan White Part B, Carson City, NV Alameda County Office of AIDS Administration, Oakland, CA UKSM-W MPA HIV Program, Wichita, KS Ryan White Part A Las Vegas TGA, Las Vegas, NV Shasta Community Health Center, Redding, CA Matthew 25 AIDS Services, Henderson, KY Northern Nevada HOPES, Reno, NV Center for AIDS, Research Education & Services, Sacramento, CA University of Kentucky, Lexington, KY Health and Education Alternatives for Teens (HEAT Program), County of San Diego HIV, STD and Hepatitis Branch, San Diego, University of Louisville Research Foundation/Wings Clinic, Brooklyn, NY CA Louisville, KY Kings County Hospital Center, Brooklyn, NY UCSD Mother-Child Adolescent HIV Program, San Diego, CA FACES, Baton Rouge, LA NYC HHC East New York Diagnostic & Treatment Center, UCSD Owen Clinic, San Diego, CA Family Service of Greater Baton Rouge, Baton Rouge, LA Brooklyn, NY Mission Neighborhood Health Center, San Francisco, CA LSU - Earl K Long Medical Center, Baton Rouge, LA The Brooklyn Hospital Center, Brooklyn, NY Opiate Treatment Outpatient Program, DSAAM, San Francisco, CA Volunteers of America Greater Baton Rouge, Baton Rouge, LA WHMC, Brooklyn, NY Positive Health Program, San Francisco, CA New Orleans Metoropolitian Area, Harvey, LA United Way of Long Island, Deer Park, NY Tom Waddell Health Center, San Francisco, CA LSU - Hospitals/University Medical Center, Lafayette, LA North Shore University Hospital, Great Neck, NY Santa Rosa Community Health Centers/ Southwest Health Center, Southwest Louisiana AIDS Council, Lake Charles, LA Boriken Neighborhood Health Center, New York, NY Santa Rosa, CA Primary Health CAre, Marrero, LA Community Healthcare Network, New York, NY Vista Community Clinic, Vista, CA Children's Hospital New Orleans, New Orleans, LA Harlem Hospital Center, New York, NY University of Colorado Hospital, Aurora, CO Interim Louisiana State Unversity Public Hospital, New Orleans, LAMount Sinai Hospital, New York, NY Boulder Community Hospital, Boulder, CO NO/AIDS Task Force, New Orleans, LA New York Presbyterian Hospital, New York, NY Denver Health HIV Primary Care Clinic, Denver, CO Office of Health Policy and AIDS Funding, New Orleans, LA NYC Health and Hospitals Corporation, New York, NY Denver Public Health ID Clinic, Denver, CO GOCARE, West Monroe, LA NYU School of Medicine, New York, NY City of Hartford, Hartford, CT Lynn Community Health Center, Lynn, MA Ryan Chelsea-Clinton CHC, New York, NY Community Health Services, Hartford, CT Greater New Bedford Community Health Center, New Bedford, St. Luke's-Roosevelt Hospital Center, New York, NY Community Health Center, Middletown, CT MA The Family Center, New York, NY Fair Haven Community Health Center, New Haven, CT Jordan Hosiptal ACCESS Program, Plymouth, MA Weill Cornell Medical College, New York, NY Yale University School of Medicine, New Haven, CT Baltimore/Towson Part A EMA, Baltimore, MD AIDS Care, Rochester, NY Waterbury Hospital, Waterbury, CT Chase Brexton Health Services, Baltimore, MD Anthony Jordan Health Center, Rochester, NY Carl Vogel Center, Washington, DC Prince George's County Health Department HAB Clinic, Cheverly, Staten Island University Hospital, Staten Island, NY Howard University Hospital, Washington, DC MD Research Foundation of SUNY Stony Brook, Stony Brook, NY Medstar Health Research Insititute/Washington Hospital Center, Prince George's County Health Department, Largo, MD St. John's Riverside Hospital, Yonkers, NY Washington, DC Wayne State University/School of Medicine, Detroit, MI Ursuline Center, Canfield, OH Unity Health Care, Washington, DC Ingham County Health Department, Lansing, MI University Hospitals of Cleveland, Cleveland, OH Whitman-Walker Health, Washington, DC Michigan Department of Community Health, Lansing, MI Nationwide Children's Hospital FACES Program, Columbus, OH Broward County Human Services Ryan White Part A Program, Fort Minnesota Department of Human Services/Part B, St. Paul, MN Ohio Department of Health, Columbus, OH Lauderdale, FL Kansas City Free Health Clinic, Kansas City, MO HIV Resource Consortium, Tulsa, OK Children's Diagnostic & Treatment Center, Inc., Fort Lauderdale, Truman Medical Center, Kansas City, MO St. Luke's Hospital, Bethlehem, PA FL Kansas City Free Health Clinic, Kansas City, MO AIDS Care Group, Chester, PA The McGregor Clinic, Inc., Fort Myers, FL City of St. Louis Health Department, Saint Louis, MO Easton Community HIV/AIDS Organization, Easton, PA Social Services Navigators, Hollywood, FL Washington University, St. Louis, MO Two Rivers Health & Wellness Foundation, Easton, PA Hendry County Health Department, LaBelle, FL Delta Regional Medical Center, Greenville, MS Hamilton Health Center, Harrisburg, PA Borinquen Healthcare Center of Miami Dade, Miami, FL Central MS Circle of Care Program, Jackson, MS Family Health Council of Central PA, Harrisburg, PA The Center for Positive Connections, Miami, FL University of Mississippi Medical Center, Jackson, MS AACO, Philadelphia, PA Ryan White Part A Orlando EMA, Orlando, FL Mecklenburg County Health Department, Charlotte, NC Albert Einstein Medical Center, Philadelphia, PA NOFLAC, Pensacola, FL Tri-County Community Health Council, Inc., Newton Grove, NC Drexel Partnership Comprehensive Care Program, Philadelphia, PA Florida Department of Health, Tallahassee, FL AIDS Care & Educational Services, Wilmington, NC Thomas Jefferson University, Philadelphia, PA University of South Florida, College of Public Health, Tampa, FL Carolina Family Health Centers Inc., Wilson, NC Kensington Hospital, Philadelphia, PA Rural HIV Model Clinic, Albany, GA Wake Forest University Health Sciences, Winston Salem, NC Pennsylvania/MidAtlantic AIDS ETC, Pittsburgh, PA AID Atlanta Joye Bradley Health Services Clinic, Atlanta, GA ND Department of Health, Bismarck, ND Positive Health Clinic, Pittsburgh, PA Emory University, Atlanta, GA Dartmouth-Hitchcock HIV Program, Bedford, NH Scranton Temple Residency Program, Scranton, PA The AIDS Project, State College, PA Centro de Salud Familiar Dr. Julio Palmieri Ferri, Inc, Arroyo, PR SIVIF Program, Gurabo, PR Concilio de Salud Integral de Loiza, Loiza, PR PR CoNCRA, Rio Piedras, PR PR CoNCRA, San Juan, PR San Juan EMA, San Juan, PR Miriam Hospital Immunology Center, Providence, RI Thundermist Health Center, Woonsocket, RI Roper St Francis Healthcare, Charleston, SC The Medical University of South Carolina Lead Agency, Charleston, SC HIV/AIDS Council, Columbia, SC Richland Community Health Care, Columbia, SC South Carolina HIV/AIDS Council, Columbia, SC HopeHealth, Inc, Florence, SC Catawba Care, Rock Hill, SC Sandhills Medical Foundation, Sumter, SC Memphis TGA Ryan White Part A Program, Memphis, TN Shelby County Health Care Ctr d/b/a Regional Medical Center at Memphis, Memphis, TN Le Bonheur Health and Well-Being, Memphis,, TN City of Austin Health and Human Services HIV Administration, Austin, TX Brazos Valley Council of Governments, Bryan, TX Parkland Health & Hospital System, Dallas, TX Lubbock MHMR, Lubbock, TX University of Texas Health Science Center at San Antonio, San Antonio, TX Alamo Area Resource Center, San Antonio, TX University of Virginia School of Medicine, Charlottesville, VA UVA Ryan White Clinic, Charlottesville, VA Mary Washington Healthcare, Fredericksburg, VA VDH and/or DC Dept. Health, Fredericksburg, VA Loudoun County Health Department, Leesburg, VA City of Norfolk/Norfolk TGA, Norfolk, VA Virginia Commonwealth University, Richmond, VA Virginia Department of Health, Richmond, VA AIDS Response Effort, Winchester, VA Pierce County AIDS Foundation, Tacoma, WA Yakima Valley Farm Workers Clinic/ New Hope Program, Yakima, WA Univeristy of Wisconsin Hospital and Clinics HIV Care Program, Madison, WI University of Wisconsin, Madison, WI Wisconsin Division of Public Health, AIDS/HIV Program, Madison, WI Medical College of Wisconsin, Milwaukee, WI Shenandoah Valley Medical Systems, Martinsburg, WV 277 HIV providers representing 244 HIV programs in 148 cities and across 42 States/Territories have joined the Campaign so far 9 caring for 318,730 people living with HIV 10 % of Grantees by Part Ryan White Funding (n=222) 11 # of Programs by Caseload of Unduplicated Patients per Year (n=222) 12 How Do You Rate the Agency’s Level of QI Experience? (n=215) 13 To What Extent Has Your Agency Recently Engaged in Retention Activities? (n=215) 14 Introduction to in+care Campaign Measures Bruce Agins, MD, MPH 15 Technical Working Group • Chaired by Drs. Bruce Agins and Laura Cheever • Comprised of distinguished experts in the field of retention, including clinical experts, researchers, national stakeholders and other strategic thinkers from the Ryan White and other health care communities • Committee was charged to prioritize and suggest 4 retention measures to be used for this Campaign 16 1) Gaps in Care Definitions of terms as used in the numerators and denominators of this document: Patient – a patient of any age diagnosed with HIV/AIDS Provider – a health care professional who is licensed in their jurisdiction to prescribe ARV therapy, i.e., MD, PA, or NP Visit – an outpatient/ambulatory medical visit with a health care professional who is licensed in their jurisdiction to prescribe ARV therapy Exclusion criteria: Patients who are documented to be deceased, incarcerated, moved away, or transferred care during the 12-month measurement period are to be excluded from measurement 17 2) Visit Frequency Definitions of terms as used in the numerators and denominators of this document: Patient – a patient of any age diagnosed with HIV/AIDS Provider – a health care professional who is licensed in their jurisdiction to prescribe ARV therapy, i.e., MD, PA, or NP Visit – an outpatient/ambulatory medical visit with a health care professional who is licensed in their jurisdiction to prescribe ARV therapy Exclusion criteria: Patients who are documented to be deceased, incarcerated, moved away, or transferred care during the 12-month measurement period are to be excluded from measurement 18 3) Patients New to Care Definitions of terms as used in the numerators and denominators of this document: Patient – a patient of any age diagnosed with HIV/AIDS Provider – a health care professional who is licensed in their jurisdiction to prescribe ARV therapy, i.e., MD, PA, or NP Visit – an outpatient/ambulatory medical visit with a health care professional who is licensed in their jurisdiction to prescribe ARV therapy Exclusion criteria: Patients who are documented to be deceased, incarcerated, moved away, or transferred care during the 12-month measurement period are to be excluded from measurement 19 4) Viral Suppression Definitions of terms as used in the numerators and denominators of this document: Patient – a patient of any age diagnosed with HIV/AIDS Provider – a health care professional who is licensed in their jurisdiction to prescribe ARV therapy, i.e., MD, PA, or NP Visit – an outpatient/ambulatory medical visit with a health care professional who is licensed in their jurisdiction to prescribe ARV therapy Exclusion criteria: Patients who are documented to be deceased, incarcerated, moved away, or transferred care during the 12-month measurement period are to be excluded from measurement 20 Campaign Measures • • • • 21 Frequency of Visits (every 6 months) Gaps in Care (no visit in the last 6 months) Patients New to Medical Provider (every 4 months) Viral Suppression (last VL, <200 copies/ml, all pts in care) in+care Campaign Data Reporting Michael Hager 22 Campaign Database • • • • • 23 Allows participating agencies to self-report their performance data on this online application Individual agencies need to register to access the database Form a group of grantees, which would allow them to generate group reports, such as HIVQUAL regional groups, collaboratives, networks Immediate access • to individual scores trended over time • to regional/national benchmarking reports • to reports based on common search criteria • to group scores of established groupings Coaches have access to individual/groups scores to better assist participating agencies Registration 24 Data Entry 25 Data Entry 26 Data Reporting 27 Data Collection Details • First Data Collection Submission Deadline: December 1, 2011 • Measurement Period: 10/01/2010 – 09/30/2011 • Access to in+care Campaign Database: incareCampaign.org/database • Testing of in+care Database: till November 4, 2011 - data are deleted on 11/4 • Database Instructions: incareCampaign.org 28 Progress Report Form A) What recent interventions have you tried to improve retention rates? What measurable results, if any, did you have? Focus on identifying those out of care; re-engaging individuals back into care; preventing those in care from falling out of care B) What are the major recent barriers/challenges you are facing in achieving higher retention rates? Focus on barriers your consumers have identified, challenges that your providers have identified; underlying system issues in your organization C) What lessons did you learn that would be helpful to others? Focus on recent discoveries that made a vast difference to your retention efforts; tools, forms (please attach); observations from provider and consumers D) What technical assistance needs to you have for NQC, HAB and our Campaign coaches? 29 Local Quality Champions Michael Hager 30 Local Quality Champions Create peer learning opportunities for HIV providers 1. Meet locally face-to-face/virtual to discuss retention issues Takes advantage of existing meeting structures and communities of learning, including HIVQUAL Regional Groups, cross-Part meetings, network meetings 2. Build regional peer exchanges with minimal input by Campaign coaches 3. Extend the reach and impact of the Campaign 31 Quality Champions Wanted! Responsibilities of Quality Champions: • Conduct at least 2 face-to-face meetings/calls • Reach out to local HIV providers; NQC will assist • Provide logistical support for these meetings • Facilitate the discussions and chair the meetings • Report activities back to Campaign staff Sign-up to become a Quality Champion – [email protected] 32 Consumer Engagement in the in+care Campaign Bob Tracy 33 Partners in+care Promote awareness among consumers about the Campaign and how to improve health by being in care Encourage self-care among consumers Reaching out to consumers and step up as partners in quality improvement activities 34 Consumer Engagement Web Site. Resources. Announcements. Consumer Corner. Sign-up to be in+care partners. Tools. in+care poster and brochure. Training. Consumer webinar series for individuals and groups. Quality Academy. Stories and Tips. People living with HIV sharing in+care stories and tips. 35 Time for Questions and Answers 36 Next Steps • Campaign Webinar: November 9, 2011 at 12pm ET • Meet the Author – Dr. Edward Gardner: November 16, 2011 at 12pm ET • First Data Collection Submission Deadline: December 1, 2011 37 Campaign Headquarters: National Quality Center (NQC) 90 Church Street, 13th floor New York, NY 10007 Phone 212-417-4730 [email protected] incarecampaign.org youtube.com/incarecampaign 38