Improving Client Improving Client Retention in Primary Retention in Primary

Care Care QI ProjectQI Project ReviewReview

Title I Case ManagementTitle I Case ManagementHIV Quality Learning HIV Quality Learning

NetworkNetworkJune 28, 2007June 28, 2007

November 2006, Learning Network MeetingNovember 2006, Learning Network Meeting:: ““Reflections on Retention”Reflections on Retention”

Rationale for Focusing on RetentionRationale for Focusing on Retention

Considering Interventions Based Upon ResearchConsidering Interventions Based Upon Research

MeasurementMeasurement

Quality Improvement and RetentionQuality Improvement and Retention

URS to Measure and Improve RetentionURS to Measure and Improve Retention

The Learning Network’s Role In Addressing Retention The Learning Network’s Role In Addressing Retention

Provider Presentations - Applying QI to Address Provider Presentations - Applying QI to Address

RetentionRetention

Improving Client Retention in Improving Client Retention in Primary CarePrimary Care

QI Project SelectionQI Project Selection

December –January, Learning Network SurveyDecember –January, Learning Network Survey

29 of 30 - “yes” to Learning Network-wide 29 of 30 - “yes” to Learning Network-wide Project Project

Teams are established with common Teams are established with common “themes”:“themes”:

co-located w/ primary care clinicco-located w/ primary care cliniccontracted/visiting primary care providerscontracted/visiting primary care providerslocated in the Tri-County arealocated in the Tri-County areatarget population - incarcerated & recently target population - incarcerated & recently

releasedreleasedtarget population - immigrantstarget population - immigrantstarget population - homelesstarget population - homeless

Improving Client Retention in Improving Client Retention in Primary CarePrimary Care

QI Project SelectionQI Project Selection

Improving Client Retention in Improving Client Retention in Primary CarePrimary Care

Learning Network-wideLearning Network-wide QI QI Project Project DevelopmentDevelopment

February 2007, Learning Network MeetingFebruary 2007, Learning Network Meeting:: Quality of Case Management DocumentationQuality of Case Management Documentation

Primary Care Status Measure Review – 2005 Baseline Primary Care Status Measure Review – 2005 Baseline

Reports from the Field – HHC and ASC Lower Reports from the Field – HHC and ASC Lower ManhattanManhattan

Learning Network-Wide QI Project Teamwork Learning Network-Wide QI Project Teamwork

Team roles and responsibilitiesTeam roles and responsibilities

Identifying causes and a “root cause”Identifying causes and a “root cause”

Brainstorming Solutions/Changes to address a “root Brainstorming Solutions/Changes to address a “root cause”cause”

Planning a Small-Scale Test of a ChangePlanning a Small-Scale Test of a Change

Results of February’s MeetingResults of February’s Meeting Common Retention MeasureCommon Retention Measure::

Clients should have a visit with their primary care Clients should have a visit with their primary care provider at least once every 6 months.provider at least once every 6 months.

QI Project AimQI Project Aim::Increase the number of patients who have Increase the number of patients who have connected to medical care and are retained.connected to medical care and are retained.

Overarching Learning Network QI Project Overarching Learning Network QI Project GoalsGoals::Demonstrate measurable improvements to client Demonstrate measurable improvements to client retention and engagement in primary care across retention and engagement in primary care across the Title I Case Management Learning Network the Title I Case Management Learning Network

Share the identified best practices across the Title I Share the identified best practices across the Title I Learning Network(s), with key stakeholders Learning Network(s), with key stakeholders including primary care providers, other supportive including primary care providers, other supportive service providers and fundersservice providers and funders

QI Project PlanQI Project PlanFebruary - AprilFebruary - April

Agency QI Project Teams Meet toAgency QI Project Teams Meet to::

-- Review PCSM and 2005 performance Review PCSM and 2005 performance datadata

- Utilize QI project “team” toolsUtilize QI project “team” tools

- Share info from LN meetings, utilize Share info from LN meetings, utilize tools where helpful and get QI project tools where helpful and get QI project teams feedback on the best strategy to teams feedback on the best strategy to testtest

QI Project PlanQI Project Plan

February - AprilFebruary - April (continued)(continued)

QI Training Available to T-I Agency QI Training Available to T-I Agency StaffStaffOption 1Option 1: : On-line Training Module(s)On-line Training Module(s)The Model for ImprovementThe Model for Improvement - - PDSAPDSA

Option 2Option 2: : @ AIDS Institute@ AIDS InstituteBasic QI WorkshopsBasic QI Workshops

QI Project PlanQI Project Plan(continued)(continued)

February – April: QI Test of Change February – April: QI Test of Change Worksheet:Worksheet:Task: Plan to Test a Strategy Task: Plan to Test a Strategy

April - May: CM Program’s QI Project April - May: CM Program’s QI Project TeamTeamTask: Implement at least one rapid cycle test Task: Implement at least one rapid cycle test of changeof change

May:May: Collaborative Team CallCollaborative Team CallTask: Share the progress of your test of Task: Share the progress of your test of changechange

. . . . . .

QI Project PlanQI Project Plan(continued)(continued)

June 28June 28 - Quality Learning Network QI Project Teamwork: - Quality Learning Network QI Project Teamwork:

3 Tasks3 Tasks::

Evaluate Title I Learning Network’s Team ProgressEvaluate Title I Learning Network’s Team Progress Discuss Each Program’s QI Project - Feedback & Planning of Next Discuss Each Program’s QI Project - Feedback & Planning of Next

StepsSteps Select Select Best Overall Quality Improvement & Best Use of a PDSA Cycle Best Overall Quality Improvement & Best Use of a PDSA Cycle

(“Rapid Cycle”)(“Rapid Cycle”)