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Quality Management

Quality Statement and Plan / Performance Measurement and Outcomes

Quality Statement

The Oregon HIV Care and Treatment Program (HCT) is committed to developing, evaluating and continually improving a statewide, quality continuum of HIV care, treatment and supportive services that meets the identified needs of persons living wtih HIV and their families, ensures equitable access and decreases health disparities.

The HCT Program supports this mission by gathering data and information about the services delivered by HCT and its contractors, analyzing this information to measure outcomes and quality of services, reporting this analysis in order to identify areas requiring needed planning, and implementing improvement activities in order to meet program goals.

Quality Management Plan

Improving and assuring quality services for persons living with HIV begins with planning. The HIV Care and Treatment Program's Quality management (QM) program includes HIV program leaders who are responsible for planning and prioritizing quality improvement goals and projects for the year, and establishing performance measures.

The Quality Management Plan outlines how the QM program is structured and how the QM program establishes responsibility and accountability for performance measurement and ongoing program evaluation and improvement.

HIV Care and Treatment Performance Measures:

Performance measure data are collected and analyzed for health disparities across target populations by the HIV Care and Treatment program. HIV Community Services sub recipient Agency providers analyze this data and provide a semi-annual performance measure narrative plan for meeting unmet goals.

HIV Care and Treatment clients (CAREAssist and HIV Community Services) who received a service in the Calendar Year (CY), regardless of funding source:
  1. Virally Suppression: 90%[1] clients will have a HIV viral load less than 200 copies/mL at last HIV viral load test during the year.
  2. In Care/Retained in Care[2]: 90%[3] of clients will have a HIV medical visit within 12 months (as measured by CD4 or VL Lab). 
HIV Community Services clients:
  1. MCM Care Plan: 90% of medical case management (MCM) clients will have a MCM care plan developed and/or updated 2 or more times a year.
  2. Stable Housing: 95% of clients will have stable housing.
CAREAssist clients:
  1. Application Determination: 95% of CA applications[4] approved/denied for new CA enrollment within 14 days of CA receiving complete application in the year.
  2. Eligibility Recertification: 95% of CA enrollees reviewed for continued CA eligibility two or more times a year.

HIV Care and Treatment Quality Management (QM) outcomes:

The HIV Care and Treatment program will collect and analyze Quality Management (QM) outcomes quarterly, which includes HIV Care and Treatment HIV Care Continuum and HIV Community Services Quality Improvement (QI) projects, and will provide this data to our HIV Community Services subrecipients annually.

HIV Care Continuum
HIV Care and Treatment: CAREAssist and HIV Community Services:

  1. Enrolled: clients who received a service in CY.
  2. In Care: Clients who received at least one service and had at least one CD4 or VL lab reported in CAREWare (CW) in CY. Goal=90%[5]
  3. Suppressed: Clients who had HIV viral load less than 200 copies/mL at last HIV viral load test in CY. Goal=90%
State of Oregon:
  1. Infected: Total HIV-infected in Oregon, diagnosed and not diagnosed
  2. Diagnosed: Confirmed HIV cases living in Oregon
  3. In Care: One or more CD4 or viral load result reported in CY
  4. On Treatment[6]: Medical Monitoring Project estimate of 97% of in-care patients on ARVs
  5. Suppressed: Percent of resident HIV cases whose last viral load in CY was < 200 copies/mL
  6. New HIV diagnosed clients only:

    Linked to Care: New HIV diagnosed clients will attend a routine medical visit within 30 days of HIV diagnosis, as measured by VL or CD4 (lab test). Goal=85%[7]

Quality Improvement project
HIV Community Services
Objective: ensure clients have a HIV medical visit and a current viral load within the CY, in order to increase viral suppression. Goal= 90%
  • HIV Case Management client with no current viral load test in 12 months will be assigned a high Medical Case Management Acuity. Goal=100%
  • HIV Case Management clients who are virally unsuppressed will be assigned a high Medical Case Management Acuity. Goal=100%

 

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[1] Oregon HIV/STD/TB Program Strategic Plan goal

[2] Formerly, "No Gap in HIV Medical Care", revised for HCS FY18-19.  In Care is part of HCT Care Continuum and uses the same definition as CDC's HIV Care Continuum "Receipt of Care"

[3] Oregon 2017-2021 Integrated HIV Prevention and Care Plan "Retained in Care" goal

[4] New applications of clients received complete in CY who were never enrolled before

[5] Oregon 2017-2021 Integrated HIV Prevention and Care Plan "Retained in Care" goal

[6] Medical Monitoring Project estimate of 97% of in-care patients on ARV's

[7] Oregon 2017-2021 Integrated HIV Prevention and Care Plan goal

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