Engaging High-Risk Populations in Care A Quality Improvement Approach Background: Developed by Associates in Process Improvement Intended to accelerate improvement, not to replace existing models organizations already use “PDSA”; “Rapid Cycle Improvements”; “Pilot Testing” 1

Learning Objectives Participants will use basic Quality Improvement methodology to collaboratively identify: Factors affecting engagement in HIV primary care for specific populations at high-risk for HIV. Innovative and collaborative strategies to engage these same high-risk populations in HIV primary care.

Target Populations Substance Users Homeless Young MSM In In the HIVQUAL model, planning a pilot test is part of Step 4 in the project cycle: Project team plans and tests change(s).

Welcome and Introductions Please introduce yourself and share: With which of the populations listed above do they have the most experience? What are you hoping to learn from this sessions discussion?

Part I: Group Discussion Causal Analysis Session 1 Part I: Group Discussion Causal Analysis 1. Individually, review the attached Causal Analysis Matrix 2. As a group, use the matrix as guide to discuss the barriers to engaging each of the target population in primary care: Substance Users Homeless Young MSM 3. Recorders, please write down the factors affecting access to care for each population on large newspaper print. To be used for Part II. RWCA Regional Conference Session 1 HIVQUAL/National Quality Center(NQC)

Transition Please select a population that you would like to focus on further for Part II: Identifying Innovative and Collaborative Strategies 2. Please join your selected group in the room -Substance Users -Homeless -Young MSM

Part II: Group Discussion Identifying Innovative Strategies As a group, review the barriers to care & circle those causes which are most influential to improving access to care for this population. Select one cause that is worth pursuing and can be undertaken relatively quickly and easily. Brainstorm innovative and collaborative strategies to address this cause. Record and large news print. Be prepared to report to the full group your most innovative strategy

Take Home Select one strategy from the list developed by your group to test in your program. Selection criteria: Focused. Does the strategy have well defined parameters? Supportable. Can staff/leadership live with proposed change Immediate. Will the strategy improve care/quality relatively quickly? Measurable. Can improvement be measured to track progress?

Take Home Select one strategy selected from the list developed by your group that you can share with your team and potentially test at your agency. (see next slide for selection criteria)

Selection Criteria Focused. Does the strategy have well defined parameters? Supportable. Can staff/leadership live with proposed change Immediate. Will the strategy improve care/quality relatively quickly? Measurable. Can improvement be measured to track progress?