1. end+disparities Learning Exchange: Working Together as a Community to end+disparities December 15, :00-2:30 pm ET Michael Hager and Nanette Brey Magnani, NQC Shaw-Ree Chen, Ashley Hann, Shawntrell Miles, Kim Smith, MCPETE Kate Burnett-Bruckner, Cuyahoga County Board of Health
Michael
Welcome to our special double header webinar and a warm welcome to all participants.
On behalf of the National Quality Center, we are excited to announce the launch of our newest improvement initiative in partnership with the HRSA HIV/AIDS Bureau – the end+disparities Learning Exchange.
Our program today includes two parts. From 1-2 we will focus on setting baseline disparity data. From 2-3 we will focus on Partners in+care 

2. Before we start… Please type your name, organization, city and state in the chat room
Michael
Please note that this webinar is being recorded for later replay by those who missed the call.
Before we start our webinar, let’s take a moment and ask participants to introduce themselves via our chat room, which can be found on the right hand side of your screen, just underneath the participants section. There is a small box labelled Chat.
Please enter your name, organization, city, and state so others can see who we have on the call today.

3. Ground Rules for Webinar Participation
Actively participate and write your questions into the chat area during the presentation
Do not put us on hold
Mute your line by pressing the microphone button to the right of your name
Please complete the post-webinar evaluation
This call is recorded for replay for those who missed the webinar
Ground rules for todays webinar:
- Actively participate and write your questions into the chat room; we have several staff and consultants who will answer your comments – I want to thank them and HAB representatives
- Please mute your phone line; you can press the microphone button to the right of your name
- Please complete the post-webinar evaluation, which will be sent to your at the conclusion of the webinar. We look forward hearing from you.
- As stated earlier the call will be recorded for replay for those who missed the webinar

4. Chep Maritim, RN, MPH, MS, MBA
Nurse Consultant, HRSA-HAB
Michael introduces Emily and Clemens
Michael turns it over to Emily to provide words of welcome
Emily turns it over to Clemens to provide words of welcome
Clemens Steinbock, MBA
Director, NQC

5. The end+disparities Learning Exchange a 9-month initiative that promotes the application of improvement interventions to reduce HIV-related disparities in four key subpopulations while building and sustaining a community of learners among Ryan White HIV/AIDS Program recipients. The Learning Exchange offers informational opportunities by content experts and utilizes the power of peer learning to facilitate local improvement efforts on eliminating HIV-related disparities.
Michael

6. Communities of Learning: collaborative, QI campaign, Regional Groups
Consultation: On/off-site coaching of recipients to advance their clinical quality management programs
Together, we can make a difference in the lives of people with HIV. NQC provides assistance to RWHAP recipients to improve HIV care since gaps in HIV care still exist and advances are uneven across HIV populations.
250 recipients participated in 28 Regional Groups
51% of all recipients joined the largest HIV QI campaign; viral suppression increased from 70% to 76%, a statistically significant improvement
Training and Educational Fora: monthly webinars, advanced trainings, online QI tutorials
40% of RWHAP recipients received TA and 95% would recommend TA to others
40 online QI tutorials are available; over 35,000 have been taken so far
Intensity
Information Dissemination: monthly newsletters, websites, publications, exhibits, QI awards
Michael
NQC is funded by the HRSA HIV/AIDS Bureau since 2004 and provides technical assistance to all RWHAP recipients to build their sustainable clinical quality management programs. Over 90% of all recipients have accessed intensive NQC offerings and take advantage of our various services. The Learning Exchange is an extension of these offerings.
As you see in this graphic, NQC provides opportunities
To participate in monthly webinars to learn more about QI – next week’s webinar focuses on the 2016 NQC Award winners
To attend our 4 3-day face-to-face training programs or take one of 40 online tutorial we have available
To request onsite assistance by our pool of QI experts
To join one of our 28 Regional Groups, a local community of learning
If you would like to learn more, please visit our website at NationalQualityCenter.org.
over 90% of the 587 RWHAP recipients accessed NQC services
~1,300 individuals (61% of recipients) graduated from 45 three-day advanced trainings
NationalQualityCenter.org |

7. Agenda Welcome & Introductions
Discussion on Community Efforts to end+disparities
Cuyahoga TGA Presentation
MCPETE Presentation
Q & A Session
Michael

8. Learning Objectives
List who should be involved in helping to solve disparity issues
Describe the principles of stakeholder engagement as it relates to community team building
List strategies that maintain team focus on the collective QI project
Michael

9. Working as a Community to end+disparities
Nanette

10. Definitions What is a community and how do we define that?
How do we bring together individual agencies to become a community?
what role to supportive services have?
What role do consumers have?
What role do non-traditional partners (i.e., places of worship and others) have?
Nanette

11. Recap! December 2 Office Hours
Nanette – 3 minutes MAXIMUM to recap December 2.
Let’s quickly summarize some of the discussion points from office hours to further spread learning across EDLE events
MATERIAL BELOW TAKEN DIRECTLY FROM OFFICE HOURS AND IS A GUIDE FOR RECAPPING DISCUSSION
Q: What do people mean by team? (CQM committee meetings? Board meetings? Staff? HQRG or other project based groups? Multidisciplinary teams? Networks?)  What are primary groups folks said they are working with?
Q: Commonalities to focus/revolve around – meeting management, group dynamics, task management/tracking. Motivations/demotivations  What are primary commonalities, dynamics, and motivators named?
Q: Goal determination, clarity of purpose and goals, tracking and carrying through  what are the purpose and goals for teams working together?
Q; Open up to talk about issues that they are facing or questions they have in working with their teams.  any final emerging themes from December 2 to highlight here? 11

12. MCPETE: Monroe County Partnering to End the Epidemic
Nanette – 3 minutes MAXIMUM to recap December 2.
Let’s quickly summarize some of the discussion points from office hours to further spread learning across EDLE events
MATERIAL BELOW TAKEN DIRECTLY FROM OFFICE HOURS AND IS A GUIDE FOR RECAPPING DISCUSSION
Q: What do people mean by team? (CQM committee meetings? Board meetings? Staff? HQRG or other project based groups? Multidisciplinary teams? Networks?)  What are primary groups folks said they are working with?
Q: Commonalities to focus/revolve around – meeting management, group dynamics, task management/tracking. Motivations/demotivations  What are primary commonalities, dynamics, and motivators named?
Q: Goal determination, clarity of purpose and goals, tracking and carrying through  what are the purpose and goals for teams working together?
Q; Open up to talk about issues that they are facing or questions they have in working with their teams.  any final emerging themes from December 2 to highlight here? 12

13. Monroe County Partnering to End The Epidemic (Est. 10/2015)
Mission: To end the HIV/AIDS epidemic in Monroe County by 2020 through the development of county wide partnerships of HIV clinical and non-clinical service providers, consumers and networks committed to specific objectives and activities that align with the New York State End the Epidemic (ETE) initiative.
Monroe County Partnering to End The Epidemic (Est. 10/2015)
MCPETE TEAM!

14. McPEtE Structure Managing Team
Monroe County Department of Public Health (Nursing Division) (MCDPH)
Technical Advisor
New York State Department of Health AIDS Institute (NYSDOH AI)
Core Team (meets monthly)
Consumer, MCDPH , Jordan Health, Catholic Charities Community Services (CCCS), Action for a Better Community (ABC), Trillium Health

15. Partners in the Collective (meet every 2 months)
Clinical
Non-Clinical
Consumers
Trillium Health (RW-funded)
Jordan Health
URMC
Rochester Victory Alliance (HIV
Vaccine Clinical Research)
Strong Memorial Hospital
Infectious Disease Clinic
National Center for Deaf Health
Research
WISH (Women’s Initiative Supporting Health)
Huther Doyle (Substance Use Treatment Agency)
Monroe County Dept of
Public Health
NYSDOH AIDS Institute
Catholic Charities (CCCS), ABC/AFC – Action Front
Center
Partners Advocating for Community Change
(PACC),
Black Leadership
Commission on AIDS
(BLCA)(includes members
of faith community)
RATFA (Rochester Area task Force on AIDS)
7 Monroe County TCQ Graduates who serve as full members; train other consumers in NYS on consumer involvement in QI; participate in agency consumer groups and QI

16. Key Objectives by 2020 Increase by # of Newly Diagnosed (ND) by 20%
100% ND Linked To Care within 3 Business days
Increase Retention from 88% to 95%
Re-engage 95% of clients Out Of Care
Increase Viral Suppression from 83% to 95%
October 27th, November 17th meetings – To reach agreement on project focus
Increase PrEP/PEP Referrals
7. Community Involvement in Clinic Trials

17. MCPETE “County Wide Viral Load Suppression”
3 Clinical Programs to take the lead
Anthony Jordan
Trillium Health
Unity Infectious Disease

18. Organizations with Data Included
Number of patients
Anthony Jordan
190
Trillium
800
Unity Infectious Disease
125
TOTAL
1115

19. Overall demographics: Race

20. Overall Demographics: Gender

21. Overall demographics: MCPETE Data

23. Demographics within Female Patient Groups (Total vs Unsuppressed)

24. Proof of Disparity between groups and Total Population (NQC Disparity Calculator)
Information from the NQC disparity calculator is shown here. Hispanic/Latino patients are shown to demonstrate that a group we recognized did not have disparities from the bar chart did, indeed come up as having no disparity in the NQC calculator.
The group chose to focus on all female patients, for reasons that Kim will explain

25. Demographics within Female Patient Groups (Total vs Unsuppressed)
Additional demographics of female patients are shown here. Within females, the subgroup that shows additional disparities compared to female patients are African American female patients.

26. In summary, As a collective the group decides to focus on improving:
VL suppression rates in women years old and
VL suppression rates in African American women particularly patients at Trillium Health.

27. Cuyahoga County Board of Health: Cleveland TGA Efforts to end+disparities
Kate Burnett
Kate describes process where Health Disparities Calculator is disseminated across the Part A sub-recipients in Cleveland TGA. The data are entered into the calculator by the sub-recipients and then sent back to Kate for review and aggregation. In addition, the sub-recipients are sending three promising next steps along with their data. Kate is aggregating these centrally to create work groups! 27

28. What is Realistic?
There is a difference between collective/team level and the individual CQM teams at RWHAP provider agencies.
Nanette

29. Q&A Session
Michael
Now we open the discussion to general inquiries for the next 30 minutes.

30. Closing Remarks Michael then to Clemens and Chep Clemens Steinbock
Chep Maritim

31. end+disparities Video
Visit our NQC YouTube channel to see our 3min video about disparities in HIV care -
Michael
A reminder to check out our video and the website!
Another cool informational tool that we have developed is a short animated video about disparities in HIV care and outcomes. Please take a look and feel free to share with others. 31

32. We Want Your Feedback!
Please complete the evaluation that is being ed to you. This quick survey will allow us to hear from you and make changes to upcoming webinars.
Michael

33. THANK YOU!
Michael

34. 212-417-4730 NationalQualityCenter.org Info@NationalQualityCenter.org
Michael 34