GOAL:To assess HIV program capability for achieving excellent results and outcomes in areas that are central to providing high quality HIV care.
A system for monitoring and assessing clinical outcomes is a fundamental component of high-functioning quality management programs. This system includes analysis of a relevant set of measures, trending results over time, stratifying data by high-prevalence populations (see G2) and comparison of results to a benchmark report used for assessing whether the program is performing at a level comparable to other similar programs and to mark goals for further improvement. A set of appropriate measures with clearly defined numerators and denominators should be available, which includes specification of data sources from which they are collected. Viral suppression rates should be included in the set of clinical measures.
*Possible data sets for comparison include HIVQUAL, HAB, In+Care Campaign, regional groups, RSR, VA, Kaiser, HIVRAD.
G.1. To what extent does the HIV program monitor patient outcomes and utilize data to improve patient care? Each score requires completion of all items in that level and all lower levels (except any items in level 0).
Getting started
0
Data:
Clinical performance results are not routinely reviewed or used to guide improvement activities.
Planning and initiation
1
Data:
Viral suppression data are used to guide improvement activities.
Longitudinal trends for viral suppression rates are reported for the last 24 months to determine improvement.
Beginning implementation
2
Data:
Trends for viral load suppression are reported and show improvements over the last two years.
Results for outcome measures, including viral suppression, are routinely reviewed and used to guide improvement activities.
Implementation
3
Data:
Trends for viral suppression rates for the active caseload show a measurable and clinically meaningful improvement when compared to the previous annual rate, greater than the margin of error, that can be linked to the improvement efforts.
Analyses of outcome performance data are openly shared with stakeholders, including consumers.
Progress toward systematic approach to quality
4
Data:
Results for open patients with unknown HIV care status are reviewed at least annually and are used to guide improvement activities.
Viral suppression rates are equal to or greater than the 75th percentile of the statewide comparative dataset.
Improvement goals are met for most newly diagnosed and established patient cascade measures, including open patients, who are known to be engaged in care and viral suppression.
Full systematic approach to quality management in place
5
Data:
Viral suppression rates for all patients, including open patients of unknown HIV care status, are consistently above the 75th percentile of the comparative dataset over a three-year timeframe.
Ascertainment of the care status of open patients is reviewed as part of scheduled quality management activities and adjustments to improvement efforts goals are made in response.
Improvement goals are met for at least 75% of organizational treatment cascade measures including viral suppression, open patients whose care status is known, and newly diagnosed patients linked to care within three days.