A quality improvement study based in a primary care resident-based HIV clinic, the Kendig Clinic, was conducted within Jefferson Family Medicine Associates. The study objectives were to
• Determine the percentage of the clinic patients meeting each quality measure
• Compare these calculated clinic measures to known national averages
• Use the data to determine areas to target for future quality improvement initiatives.https://jdc.jefferson.edu/cwicposters/1019/thumbnail.jp

Lacue, Amanda

Miller, MD, Marshall

English

A quality improvement study based in a primary care resident-based HIV clinic, the Kendig Clinic, was conducted within Jefferson Family Medicine Associates. The study objectives were to
• Determine the percentage of the clinic patients meeting each quality measure
• Compare these calculated clinic measures to known national averages
• Use the data to determine areas to target for future quality improvement initiatives.http://jdc.jefferson.edu/cwicposters/1019/thumbnail.jp

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Quality of Care Assessment at a Resident-based Primary Care HIV Clinic

Jefferson Digital Commons

Thomas Jefferson UniversityJefferson Digital CommonsCWIC Posters Jefferson College of Population Health11-30-2016Quality of Care Assessment at a Resident-basedPrimary Care HIV ClinicAmanda LacueThomas Jefferson University, amanda.lacue@jefferson.eduMarshall Miller, MDThomas Jefferson University Hospital, Philadelphia, PA, marshall.miller@jefferson.eduFollow this and additional works at: http://jdc.jefferson.edu/cwicpostersPart of the International Public Health CommonsLet us know how access to this document benefits youThis Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of ThomasJefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarlypublications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers andinterested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion inCWIC Posters by an authorized administrator of the Jefferson Digital Commons. For more information, please contact:JeffersonDigitalCommons@jefferson.edu.Recommended CitationLacue, Amanda and Miller, MD, Marshall, "Quality of Care Assessment at a Resident-based Primary Care HIV Clinic" (2016). CWICPosters. 19.http://jdc.jefferson.edu/cwicposters/19Abstract A quality improvement study based in a primary  care resident-based HIV clinic, the Kendig Clinic, was conducted within Jefferson Family Medicine Associates.  The study objectives were to  •  Determine the percentage of the clinic patients meeting each quality measure •  Compare these calculated clinic  measures to known national averages •  Use the data to determine areas to target for future quality improvement initiatives.  Introduction HIV Quality Improvement •  National HIV/AIDS metrics established to help reduce the number of patients infected with HIV, increase access and health outcomes, and reduce HIV health disparities. 1 •  Continuous measurements of HIV providers quality of care is an essential component  endorsed by the HIV Medicine Association of the Infectious Disease Society of America 2 •  Higher adherence to ARTs has been found in patients that are engaged in care and have higher appointment adherence3 •  Assessment of these, along with assessment of other HIV conditions, were included in the National HIV/AIDS metrics 1 Results Sixteen patients charts were reviewed to assess the quality of the clinic. Each patient did not qualify for each metric, and thus each metric had differing eligible numbers.  Percentages of Clinic Patients Meeting Quality Measure  Discussion •  The clinic percentage completion of each of the measures was compared to twelve known national average.  In comparing those averages it was found that: •  The Kendig Clinic did better than national average 41%  of time •  Exceeded national average on 5 measures •  Lower than national average on 7 measure •  The percentages will allow for future monitoring of clinic performance,  and allow for them to determine if applied quality improvement interventions in the clinic are successful.  •  Meeting the metrics at higher standards assures that patients receive care that best helps to manage their disease and their health.  Conclusion Quality of care assessments are critical for determining the care administered to HIV patients. The clinic care assessment allowed for:  •  The metrics that the clinic is meeting with success •  The metrics that the clinic is not successfully meeting •  The areas that can be targeted for quality improvement initiatives allowing for  the improvement of HIV care Future quality improvement for the clinic involve: •  Working with the  infectious disease department to help patients meet the metrics concerning primary  care.  •  Implementation of a resident-checklist as a learning tool for the management of HIV-positive patient care  References 1.  Horberg MA, Aberg JA, Cheever LW, Renner P, O'Brien Kaleba E, Asch SM. Development of national and multiagency HIV care quality measures. Clin Infect Dis. 2010;51(6):732-738. doi: 10.1086/655893 [doi]. 2.   Gallant JE, Adimora AA, Carmichael JK, et al. Essential components of effective HIV care: A policy paper of the HIV medicine association of the infectious diseases society of america and the ryan white medical providers coalition. Clin Infect Dis. 2011;53(11):1043-1050. doi: 10.1093/cid/cir689 [doi]. 3.  Sullivan LM, Stein MD, Savetsky JB, Samet JH. The Doctor–Patient relationship and HIV-infected patients' satisfaction with primary care physicians. Journal of general internal medicine. 2000;15(7):462-469. 4.  http://hab.hrsa.gov/deliverhivaidscare/habperformmeasures.html   Quality of Care Assessment at a Resident-based Primary Care HIV Clinic  Amanda Lacue, Marshal Miller, MD   Sidney Kimmel Medical College of Thomas Jefferson University, Thomas Jefferson University Department of Family and Community Medicine Methods •  Sixteen HIV (+) patients seen in the Kendig Clinic within one year, between the ages of 18-70,  were assessed in a retrospective, manual, de-identified chart review •  All patients that had visited the clinic one time or more were included •  Patient information was collected from each patient for each of the 23 Ryan White Quality metrics.  •  The amount of time that the clinic met each metric was calculated  •  The metrics assessed if many aspects of HIV care including STD and common coinfection screenings, viral loads, ART prescription, appointment adherence, lipid screening, vaccination, risk counseling, and others. 1 Measure	   Eligible	  No.	  	   Clinic	  Rate	  (%)	  Viral	  Load	  Counts	   13	   84.60%	  Viral	  Load	  Suppression	   16	   75%	  Prescrip>on	  An>retroviral	  Therapy	   16	   87.50%	  Adherance	  Assessment	  and	  Counseling	   14	   100%	  HIV	  Medical	  Visit	  Frequency	   8	   62.50%	  Gap	  in	  HIV	  Medical	  Visits	   10	   20%	  Syphilis	  Screening	   16	   62.50%	  MSM	  Receiving	  Syphilis	  Screening	   7	   85.70%	  Gonorrhea	  Screening	   15	   73.30%	  MSM	  Gonorrhea	  Screening	   7	   71.40%	  Chlamydia	  Screening	   15	   73.30%	  TB	  Screening	   16	   87.50%	  Hepa>>s	  B	  Screening	   16	   93.60%	  Hepa>>s	  B	  Vaccina>on	   11	   45.50%	  Hepa>>s	  C	  Screening	   16	   62.50%	  Cervical	  Cancer	  Screening	   5	   80%	  Colposcopy	  aPer	  Abnormal	  PAP	   1	   100%	  Inﬂuenza	  Vaccina>on	   16	   87.50%	  PCP	  Prophylaxis	   3	   66.70%	  Lipid	  Screening	   14	   85.70%	  HIV	  Risk	  Counseling	   16	   75%	  Mental	  Health	  Screening	   16	   100%	  Substance	  Use	  Screening	   16	   62.50%	  The clinic percentages were then compared to the known national average percentages for each of the standards. 4  0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% % Patients Meeting Measure National and Clinic Percentages Clinic Rate (%) Nat.% (HRSA) 

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Quality of Care Assessment at a Resident-based Primary Care HIV Clinic

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