Supporting Continuous Quality Improvement in HIV Care

Client: Cambridge Health Alliance
Topic Area: Healthcare delivery systems
Service: Training and Technical Assistance

Cambridge Health Alliance (CHA) is a safety-net healthcare system serving an ethnically and linguistically diverse patient population in Boston’s metro-north region. CHA operates an HIV clinic that provides clinical and behavioral health care and case management services. ICH provides TA and data services support to facilitate continuous quality improvement for CHA’s HIV Clinic. This support includes:

  • Development and implementation of a Clinical Quality Management Plan, including creation of annual goals, management of a dashboard of quality indicators, and facilitation of continuous quality improvement (CQI) processes to address areas not meeting targets
  • Working with CHA’s IT department to develop automated systems for monitoring EMR data
  • Providing TA to stratify quality indicators by race, ethnicity, and language to identify disparities.
  • Collecting patient satisfaction data through surveys, focus groups and interviews
  • Developing tools and processes to help clinic staff address gaps and barriers to care. For instance, when the case management director realized that some patients were falling through the cracks and their health insurance wasn’t being renewed in a timely manner, ICH developed a form and a process to track barriers to renewal and identify support the case managers needed to complete the process.

With ICH’s support, CHA identified that they were well below their goals in providing TB tests and pap smears to their HIV patients, with Haitian patients the least likely to receive the tests within the recommended time frame. ICH then helped clinic staff identify a variety of interventions, including earlier outreach to patients, changes to room set-up for pap smears, changing the type of TB tests utilized, and identifying which patients needed individualized support to schedule and attend their appointments.  These interventions resulted in CHA meeting and then exceeding their targets. Overall, ICH’s TA has enabled CHA’s HIV clinic to meet funder reporting requirements and to use data efficiently and effectively for program improvement.