Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #107364

Anwer Aqil, MD, MPH, DrPH, Johns Snow Inc., Senior HIS Advisor, 1616 N. Fort Mayer Drive, Arlington, VA 22209, 703-528-7474, anwer_aqil@hotmail.com and Zohra Patel, BA, MHS, International Health, Johns Hopkins University, 7016 Hopewood Street, Bethesda, MD 20817.

Background: The Department of Health's HIV/AIDS Administration, District of Columbia, under the Ryan-White grant, sponsored the review of substance abuse and mental health (SAMH) services and the capacity of service vendors in implementing the continuous quality improvement (CQI) program in 2003. The goal was to establish a comprehensive Quality Assurance and Management Program. Method: A census survey of service vendors providing SAMH) services to HIV positive clients was conducted in 2003. Facility administrators were interviewed. Records were examined for checking implementation capacity for CQI program. Client charts were reviewed for quality of care provided. American Psychiatric Association guidelines and HEDIS measures were used as indicators of quality standards of care and outcomes. Lot quality assurance sampling was used to assess quality of care provided. Results: The charts review showed that irrespective of the mental health conditions, less than 25% of the charts have information on duration of illness, phase of illness, duration of medication, and dosage. Mental health and substance abuse included: schizophrenia, depression, anxiety/panic disorder, alcohol and heroin abuse. Records have little mention of family counseling or outcomes of the treatment. Psychotherapy notes scarcely described behavioral objectives. Capacity assessment for CQI showed that vendors have neither specific clinical standards nor outcome measures for selected mental conditions. 53% of vendors showed less than three out of eight elements of CQI program. Policy Implications: Service vendors had limited capacity to provide quality SAMH services to HIV positive clients, indicating the need for capacity building and institutionalization of quality improvement programs.

Learning Objectives:

• • Identify strengths and weaknesses in quality of SAMH services provided
• • Identify gaps in capacity for implementation of continuous quality improvement (CQI) program
• • Apply lessons learned

Keywords: Quality Improvement, Research

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.