Although major advances have been made in HIV treatment and survival, studies indicate that many HIV infected-persons are not receiving effective treatment. To address this, the Health Resources and Services Administration (HRSA) has organized a quality improvement collaborative training program for Ryan White CARE Act funded primary care clinics throughout the country. Researchers at Harvard Medical School are evaluating the effectiveness of this program by comparing improvements in quality of care in participating and non-participating clinics. The study uses several methods to assess changes in quality and to identify organizational factors associated with improvement: medical record reviews measure changes in clinical care and outcomes (e.g. use of HAART therapy, viral loads, frequency of visits); surveys assess characteristics of the clinic (e.g. size, organization, services, etc.) and clinicians (e.g. HIV caseload, expertise, etc.); and a change survey evaluates the clinic leadership's and staff's readiness and commitment to implement change. Site visits have revealed potential barriers to providing high quality HIV care, including lack of leadership for change, and difficulty attracting and retaining HIV experts in inner cities and in remote rural areas. The evaluation will identify the most effective components of the collaborative training, and will point to elements of a national plan for HIV care improvement.
Learning Objectives: 1. Develop methods for evaluating quality of HIV care. 2. Recognize relevant clinical indicators of quality of care for HIV. 3. Describe organizational factors that facilitate or impede delivery of high quality HIV care.
Keywords: Quality Improvement, HIV/AIDS
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