Organizational Assessments

Organizational Quality Management Integration of HIV Supportive Service Programs and Clinical Activities

GOAL: Organizational quality management programs should actively integrate HIV programs and facilities that provide supportive services to patients with HIV; a successful quality program should demonstrate full integration by showing that QM infrastructure and QI activities include all services that address the needs of HIV-infected patients.

QM integration demonstrates a recognition of the important role of HIV supportive services that assist patients with entry and retention in HIV primary medical care, provide them with support to achieve viral load suppression, and in fact include elements that support engagement at every stage in the care continuum.

*Supportive services refers to all programs and services that support desired clinical healthcare outcomes. These may include but are not limited to care coordination programs, case management programs, food service programs, peer support and navigation programs, mental health programs, substance use programs, pharmaceutical programs, and community outreach programs, transportation programs, housing and legal service programs.

H.2. To what extent does the HIV program incorporate supportive services*, and involve their staff, in its QM program process and QI activities to improve patient outcomes along the care continuum? Each score requires completion of all items in that level and all lower levels (except any items in level 0).
Getting started 0
  • Program has no history of involving supportive service programs in QM efforts.
Planning and initiation 1
  • Supportive services conduct QI activities and have their own closed QM committee, but these are separate from the HIV clinical QM program.
  • HIV clinic QM plan does not reference supportive service activities.
  • HIV QM committee meetings occur without representation from supportive services.
Beginning implementation 2
  • Supportive service QI efforts are often separate, but they are reported to clinical QM program at the HIV QM program’s quality committee as evidenced in meeting minutes.
  • Has a communication structure in place to inform clinic and supportive services of QI activities. This may include dissemination of meeting minutes to all staff in supportive and clinical programs, newsletters, email blasts or meeting discussions documented in meeting minutes.
  • Supportive services participate in clinical HIV QM committee but in a limited manner (e.g. supportive service supervisors report on projects in supportive services, comment on clinical QI projects. However, they do not participate in integrated QI projects with both supportive services and clinical services working on the same QI team with the same QI goals).
Implementation 3
  • Includes some supportive services in clinical HIV QM program. For instance, case management and care coordination services might be included in clinical QM committee meetings while food services might not.
  • Data collection plans for supportive service programs are included as a component of the HIV QM program’s annual quality management plan.
  • Clinical committee has reviewed QI activities conducted by supportive services and has a written plan to better integrate them with clinical efforts.
Progress toward systematic approach to quality 4
  • The quality statement and goals included in the program’s annual quality plan include all HIV services.
  • Data collected in supportive service programs are reviewed and used in clinical QI efforts
  • Demonstrates through integrated quality meetings, and improvement projects as well as in the goals and activities delineated in the annual quality plan that the QM mission of clinical and supportive services are well-aligned.
Full systematic approach to quality management in place 5
  • Has a fully integrated organizational QM plan that includes annual workplans for each supportive service program, as well as integrated goals that include plans to work towards goals with collaborative QI activities including both clinical and supportive services on QI teams.
  • Representatives from all supportive service programs fully participate in the HIV QM committee.
  • Quality improvement projects routinely include and involve clinical and supportive service staff working on the QI team as evidenced in project documentation in storyboards or by other documentation that is shared with all stakeholders including consumers and staff of both supportive and clinical services.
  • Demonstrates sharing of data, QI projects, and resources to improve outcomes as evidenced in the annual HIV QM plan, QM program meetings, and documented QI activities.
  • Performance measurement and QI data are communicated widely to staff and stakeholders throughout the program, transparently sharing progress on goals and improvement outcomes.
  • Ensures that data collected in supportive service programs are reviewed and integrated with clinical program performance measurement as evidenced in the performance measurement plan included in the annual HIV QM plan.