What is a HIVQUAL Regional Group? How can it help my HIV care program? Moderator: Clemens Steinbock, Director NQC Presenter: Darryl Ng, Director HIVQUAL-US at the National Quality Center Tuesday, November 27, 2012 3:30 pm to 5:00 pm Coolidge RWA-0222

NQC and Quality Workshops at 2012 AGM

NQC at 2012 AGM Networking Opportunities - Interact with your peers… Tue, Nov 27 12pm: HIVQUAL Regional Group– Thurgood Marshall Ballroom West Wed, Nov 28 12pm: in+care Campaign - Thurgood Marshall Ballroom South NQC Exhibit Booth - Stop by our booth… NQC Office Hours - Meet one of our NQC coaches...

Agenda 3:30pm Clemens Steinbock - Welcome 3:40pm Darryl Ng - What is a Regional Group and How Does It Help My HIV Program? 3:55pm Grantee Testimonies 4:05pm Fishbowl Exercise 4:50pm Aha Moments, Next Steps, Evaluations, Wrap-up 5:00pm Adjourn

Learning Objectives Understand what HIVQUAL Regional Groups are, their purpose, and how they function Identify the benefits of HIV provider collaboration and peer learning Understand best practices for participating in Regional Groups through sharing of peer stories Synthesize the next steps for improving quality through joint initiatives

NQC and HIVQUAL Merges NYSDOH is re-funded to administer the National Quality Center (NQC) grant; funded for 5 years NQC will continue to provide existing technical assistance offerings to build capacity for quality improvement across all Parts NQC now encompasses all HIVQUAL offerings, including the successful HIVQUAL Regional Groups “The National Quality Center, in conjunction with the federal US Government, provides no-cost, state-of the-art technical assistance for all federally funded HIV providers to improve the quality of HIV care nationwide.”

Questions for the Audience Who has ever benefited from joint quality improvement efforts across multiple HIV providers? Who is aware of the HIVQUAL Regional Group in your area? Who is currently participating in a HIVQUAL Regional Group? Who has benefited from participating in a Regional Group?

What is a HIVQUAL Regional Group? HIVQUAL Regional Groups create opportunities for local HIV providers to get together regularly to explore how they can jointly improve HIV care HIVQUAL Regional Groups aim to engage all local HIV providers, across all Parts and service categories The goal of the Regional Groups is to build sustainable peer learning forums, managed by local quality champions HIVQUAL Regional Groups are supported by both NQC coaches and local assistance Regional Group meetings can be in person or virtual via webinars

What is a HIVQUAL Regional Group? Currently we have 25 Regional Groups throughout the U.S. and Puerto Rico From August 2011 through August 2012, there were 73 Regional Group meetings 196 Part C and D Ryan White grantees currently participate in Regional Groups Focus of current Regional Groups: Retention in HIV Care Viral Load Suppression Consumer Participation in QI Activities Regional Groups are supported by 10 NQC coaches, each responsible for a specific U.S. region Toolkit for Regional Groups is available to facilitate initiation and sustainability Regional Groups often collaborate on common quality improvement projects

What is the Purpose of Regional Groups? Provide local opportunities for peer learning and sharing across regional HIV providers Promote effective quality improvement strategies through ongoing exchange among peers of all Ryan White Parts Prioritize and implement quality improvement projects to address local improvement goals Build capacity for quality improvement and performance measurement Identify and support local quality improvement champions Help align Ryan White federal quality priorities with those at the state and local level Help grantees to meet Ryan White quality management requirements

Who Participates in Regional Groups? A spectrum of HIV providers and administrative staff, including medical providers, psychosocial providers, QI managers, etc.  Originally the Regional Groups focused on Part C and D-funded grantees, but now they often include grantees funded by Parts A and B and other Ryan White-funding sources Some Regional Groups also involve other HIV quality-of-care stakeholders: patients, state and local HIV program leadership, and staff of HIV training programs We encourage at least two representatives from each grantee to participate in the Regional Group meetings; these should be staff who are in positions that can “drive” change within their organizations

How Often Do Regional Groups Meet? Regional Groups can either meet in person or virtually (conference calls or webinars) Most HIVQUAL Regional Groups meet 3 or 4 times a year Face-to-face meetings usually last about 4 hours Some groups choose to meet, at least periodically, by conference call or webinar due to geographic distance; these meetings typically last 1-2 hours Meetings are facilitated by NQC Coaches or by local quality champions

Who Leads the Regional Groups? NQC coaches help launch new groups and facilitate meetings The goal of Regional Groups is to develop leadership capacity; coaches work with Regional Group members to present their projects, lead discussions, and set the group’s priorities on an ongoing basis The goal for each Regional Group is to transition the leadership and management of these groups to individual local quality leaders

What Happens at Regional Group Meetings? Members determine priority concerns that will be jointly addressed in the coming year, including: Clinical challenges (example: improving TB screening) QI infrastructure needs (example: how to write a Quality Management Plan) Operational concerns (example: waiting time) Most Regional Groups also choose one year-long QI project annually. Members conduct improvement activities on this focus and discuss progress and challenges at each Regional Group meeting  Meetings may include peer presentations and best practices, new developments in HIV treatment, training opportunities for HIV staff, changing QM requirements by funders, etc.

If We Join a Regional Group, What Will Be Required of Us? Identify one person on your staff to serve as the key contact Take part in an annual organizational assessment of the quality management program conducted by the assigned NQC Coach  Commit two staff members to actively participate in Regional Group meetings Participate in the joint QI projects when you are “back home” Develop presentations of your successful efforts to share with other grantees and the HIV/AIDS Bureau

Grantee Testimonies Self introduction (name, clinic/size, grant funding, location) Why are you a member? What does the RG do for you? Regional Group Features When it started, location Members of the group Who and how many Range of types of clinics Patients served by the RG Range of demographics Urban, rural, suburban, mixed Particular needs Uniqueness - Its Importance for its existence Example - isolated, thus RG provides a real opportunity to connect with other RW grantees to share, etc QI efforts Past and Current Success

Fishbowl Exercise

Fishbowl Exercise 1. Organize an inner circle comprising members of different Regional Groups (fishbowl). The remaining participants comprise the outer circle. The outer circle will be observing the discussion. 2. The NQC coaches will facilitate the Regional Group discussion and provide: the purpose of the meeting; a brief agenda; an introduction exercise; and the first question for discussion. 3. Observers in the outer circle listen to the discussion and write down questions they want to ask the Regional Group participants in the inner circle. 4. After about 10 minutes, the session facilitator will "break the action" of the circle discussion and ask for questions. 5. The NQC coaches will ask the observers in the outer circle to participate with feedback, questions and observations. At this point in time, they will have an opportunity to change places and sit in the inner circle. 6. When 15 minutes remain, we will close the discussion and debrief

NQC Offerings NQC Website Quality Academy HIVQUAL Regional Groups On-Site TA in+care Campaign NQC Trainings

NQC Resources

Darryl Ng, Director HIVQUAL-US National Quality Center Dwn01@health.state.ny.us 212-417-4533

National Quality Center 212-417-4730 NationalQualityCenter.org Info@NationalQualityCenter.org