Oakland Eligible Metropolitan Area
Quality Management Plan
2006-2007
Background and History
In 2000, all CARE Act programs were directed to develop and implement quality management programs. The purpose of the HRSA’s Quality Management Program is:
· To assess the extent to which HIV health services are consistent with the most recent Public Health Service (PHS) guidelines for the treatment of HIV disease and related opportunistic infections.
· To develop strategies for ensuring that such services are consistent with the guidelines for improvement in the access to and quality of HIV services.
Expectations
Emphasized in the Ryan White CARE Act Reauthorization Technical Assistance meeting held in June of 2001, Quality Management Programs are pivotal in addressing the following key CARE Act themes:
· Improve access to and retention in care for HIV+ individuals aware of their status.
· Quality of services and related outcomes
· Linkage of social support services to medical services
· Ability of the program to change with the epidemic
· Use of epidemiological and health outcome data for priority setting
· Accountability (resources, responsibility, implementation etc.)
Mission
The mission of the Quality Management Program is to ensure that all people living with HIV/AIDS in the Oakland EMA receive the highest quality of primary medical care and support services through Ryan White Care Act and other local funding.
Purpose
The Oakland EMA’s main purpose for Quality Management Programs is:
· To improve health outcomes, reduce disparities, and increase access to care.
· Improve on quality management activities currently in place;
· Implement new strategies from best practices.
Annual Quality Goals
Goal #1: To strengthen participants understanding of Continuous Quality Improvement
Activities:
o Continue to educate consumer, providers and Planning Council members on the Chronic Care Model and implementation in programs.
o Continue the “Quality Circle of Care” (Ala. /Co. Co. county staff) meetings to share and provide input into the Oakland EMA quality initiative.
o Continue CQI committee meetings to review data and initiate quality improvement strategies
o Identify needs, plan and conduct trainings for grantee staff, planning council members, and providers on data collection, analysis and presentation
o Develop and publish the standards of care. core-primary care, oral health, substance abuse, mental health and case management; housing, food, respite and day center Standards of Care
o Assist service providers in developing an annual HIV-agency specific Cross Title Quality Management Plan
o In coordination with stakeholders review/revise performance indicators, which are linked to optimal measurable outcomes for all service categories, administration and Planning Council
o Request technical assistance from HRSA regarding our quality principles and activities.
Goal #2: To improve data accuracy and integrity in the Oakland EMA
Activities:
o Continue to assess, develop and implement HIV/AIDS Client Services
System (HACS) in Alameda County.
o Provide technical assistance to contractors on measuring outcomes.
o Analyze data collected from database programs, progress reports, outcome reports and chart review
o Assist providers in producing the annual CADR report
o Conduct data management training for grantee staff, providers and Planning Council members.
Goal #3: To impact decision-making process through quality improvement data
· Ensure that all core-funded contractors conduct and/or participate in an annual, standardized, EMA-wide Client Satisfaction Survey
· Provide outcome data to Planning members for priority setting and allocations
· Present data at the CQI meetings for discussion and review of best practices
Goal #4: To focus CQI activities on substance abuse and mental health
· Review current practices for substance abuse and mental health
· Develop and implement tools for screening, referrals and follow up
· Discuss and report on specific data collected, outcomes and recommendations to planning members.
Accountability
The Oakland EMA’s leadership is dedicated to the quality improvement process and implementation of the quality management program. The Office of AIDS Administration staff is responsible for the accomplishments of the quality management program for trends and patterns that could lead to making effective changes in delivering high-quality patient care.
Leadership:
· The Oakland EMA Grantee has the overall administrative responsibility and accountability for the quality of care and services delivered. The Planning Council will be updated on QM activities on a monthly basis via the Grantee Report.
QM Staff:
· The QM team will initiate and implement quality activities, which may include chart reviews, etc. in addition to working with the service providers to address areas in which agencies may have difficulty in implementing activities.
Grantee and Program Staff: (Alameda and Contra Costa County Program Staff)
· Continue to make a more active role to support quality improvement activities in the EMA.
Planning Council:
· Review and utilize service outcome in the prioritization and allocation of Ryan White Care Act Title I awards for the Oakland EMA.
Continuous Quality Improvement Committee:
· The Continuous Quality Improvement Committee will meet at least quarterly to
discuss, plan and implement CQI activities in the EMA.
· The CQI Committee in collaboration with the service providers and consumers will meet every other month to oversee and provide feedback to quality improvement projects.
· Structure: Committee members include:
Director of Data and Quality
Medical Advisor
Program managers-2 (Alameda and Contra Costa County)
Clinical Director of Case management-Contra Costa County
QM Coordinator for Title I and II
QM Coordinator for Title III and IV
Clinical Coordinator- (Titles I and III)-AIDS Project East Bay
Substance Abuse provider (Title I)-Alameda County Medical Center
Primary Care provider (Title II, IV)-East Bay AIDS Center
Administrator- (Title II, IV) East Bay AIDS Center
Consumer (2)
Consumer Responsibility:
· Consumers who are trained may participate in grantees site visits, and will also assist with evaluation of QM activities in Oakland EMA.
Resources Oakland EMA Title I/II grantee has assigned 4.5% of the annual grant and other in-kind funding for evaluation and quality assurance activities.
Data Collection:
Implementing the HIV/AIDS Client Services System (HACS)-Alameda County and the Contra Costa Database will greatly facilitate data collection within the EMA by:
· Eliminating (or significantly reducing) duplication of intake activities wherein the client is forced to complete many of the same forms at each provider agency
· Efficiently gathering service delivery data from the provider agencies
· Assisting providers in unduplicating client numbers for reporting and planning purposes and
· Automating the production of the CARE Act Data Report (CADR).
Other data collection from: other Ryan White databases; core service chart review; progress reports; epidemiology data, including prevention and testing.
Quality activities and outcome reporting will be shared in planning council meetings; CQI meetings and other EMA sponsored meetings. Quality management activities will also be documented in the grant application.
Evaluation The grantee is responsible for evaluating the annual EMA Quality Management Plan.
· Evaluation results will be derived from the program monitoring processes, client satisfaction surveys, outcome measures, and data from client intake forms.
· Grantee QM staff will review the evaluation and recommend a plan for improvement to the Planning Council.
· Evaluation results and recommendations for service improvements across service categories will be made available to the Planning Council and consumers in a timely manner to be useful in the annual priority setting process and resource allocation decisions.
· The “Quality Circle of Care” will report activity updates to the Planning Council quarterly.
Annual updates
· The Quality Management Team will initiate annual updates.
· The final plan will be shared with the CQI committee, Planning Council member’s consumers and Cross Title contractors.
· The Office of AIDS Administration Director will give final approval.
Summary
Throughout the year, the QM staff will collaborate with service providers, consumers, CQI Committee members and the Planning Council to continuously work together to improve care, thereby making significant changes that improve clinical outcomes and reduce cost. The Oakland EMA can share the changes that work best, the “lessons learned” and, and the pitfalls to avoid. Everyone plays a valuable part in improving the quality of services provided to people living with HIV/AIDS in Oakland Eligible Metropolitan Area.
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Revised Date: 05/3/06