1. end+disparities Learning Exchange Office Hours: Strategic Planning for Disparities November 4, :00-2:00pm ET

2. Before we start… Please type your name, organization, city and state in the chat room
MICHAEL

3. 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
For more information visit our website at

4. end+disparities Video
Visit our NQC YouTube channel to see our 3min video about disparities in HIV care -
MICHAEL
Check out this informational tool that we have developed – it is a short animated video about disparities in HIV care and outcomes. Please take a look and share with your colleagues and social media networks! 4

5. Today’s Topic: Strategic Planning Office Hours
Always on Fridays at 1pm ET – variable schedule
No registration is required and open to all
Open-ended dialogue to explore specific topics
General Q & A regarding end+disparities Learning Exchange key topics
MICHAEL
Show of hands… how many people have been on previous office hours? We want to know how we’re doing and we’ll be checking in on how we can improve this activity at the end of today’s discussion.
We’d like to reinforce the point that Office Hours are driven by the participants and are an opportunity to ask questions about strategic planning today. We are also happy to delve into general questions about the end+disparities Learning Exchange.
Today’s Topic:
Strategic Planning

6. Strategic Planning LORI
Q: What does strategic planning mean to you as you consider this initiative?
Q: hat are some of the things that come to mind for you that you need to cover or discover?
Prompt: As you think about planning a project around disparities in HIV health outcomes, consider the steps that need to be taken and where you go once you have this information.
So, how do you eat the elephant? One bit at a time!
Let’s begin talking about how we strategically plan for moving this initiative forward 6

7. Chew on This!
What do you know? What do you need in order to identify and understand what the issues are?
Where do you begin? How do you focus your effort and select your population?
Who do you engage? Who needs to be at the table or involved in the planning?
What do you do to plan?
How do we sustain our gains?
Some ideas to share after the participants provide their ideas for the first bullet:
Epi data (to ID trends)
Care data (to ID populations served and not reached/served)
Anecdotes/key informant interviews/focus groups (to identify needs, issues, populations reached/served and not)
Needs assessments (to ID needs and populations not reached/served)
Some ideas to share after the participants provide their ideas for the second bullet:
NQC Disparities Calculator
NQC ShareLab
End+disparities Learning Exchange Interventions Grid
Some ideas to share after the participants provide their ideas for the third bullet:
Consumers
Champions of the targeted populations
Providers
Front line staff
Program leaders
Other Key informants
Some ideas to share after the participants provide their ideas for the fourth bullet:
Aim Statement
Root Cause Analysis
QI project memos
Gantt charts and work plans
Role delineation
Some ideas to share after the participants provide their ideas for the fifth bullet:
Routine reporting
Routine updates at staff meetings
Creation of a team to track and maintain gains
Routine presentations at conferences and meetings

8. Lori

9. Lori

10. Lori

11. MISSOURI AIM STATEMENT
MO CAN WILL USE HEROIC EFFORTS TO IMPROVE
THE HIV CARE CONTINUUM IN ORDER TO PROVIDE
IMPROVED CARE FOR OUR RESIDENTS LIVING WITH HIV
WE WILL FOCUS ON IMPROVING VIRAL LOAD SUPPRESSION
AND RETENTION WITH OUR POPULATION.
MO CAN WILL INCREASE VIRAL LOAD SUPRESSION
BY 5% BY DECEMBER 2014
MO CAN WILL DECREASE THE GAP IN MEDICAL
VISITS BY DECEMBER 2014

12. New Jersey Part D Statewide Network: Root Cause Analysis of Pap Smears
Environment
Procedures
No policy in place re: referral f/u
Lack of support services
Limited time for Pap
Referrals
EMR function to flag provider not enabled
Available services
Referrals are made with no f/u
Time
Gyn services unavailable on-site
Need for Pap
Assume pt. is already informed
Limited time to explain procedures
No process to flag need for Pap
Limited time w/ MD/NP d/t large case load
Overall clinic time limited
Co-located srvs not available
Physical space limited
Pt. understanding
Emergencies / unexpected complexity of appt.
Not enough clinic space
Space
No reminders for pt. appts.
Appts. Made without consultation with pts.
Lack of pt. education re: procedure
Staff responsibility to provide education not defined
Long wait time
Space used by other practitioners
Appointments
Walk-in appts. Delay scheduled appts.
Have to wait to use exam room
No process to remind pts. of appts.
Low rate of Pap smears
Expectations of staff
Staff not trained to use equipment
Expect pt. won’t show
Competing priorities and time commitments
Staff not aware of problems with Paps
Trained staff
Assume pt. doesn’t want to do Pap
Limited funds for equipment
Staff
Don’t want exam
Billing may not result in reimbursement
Pain
Don’t want to perform Pap
Availability of equipment
Negative past experience
Svc. not covered by malpractice insurance
Pap not in area of expertise
Patients
Specialty equipment not available. eg. tilting exam table
Mobile Pap cart not available
Of pain
Expectations of f/u on results
Equipment
Competing health priorities
Of cancer
Don’t feel its needed
Of diagnosis
Liability and billing
Too busy taking care of others
Of unknown
Cost of procedure vs. other needs
Unpleasant experience with culposcopy
People
Priorities
Fear

13. General Q & A
MICHAEL
We’d like to open up the discussion to field questions about other aspects of the initiative that participants might have.

14. Checking-in
What feedback do you have on end+disparities Learning Exchange?
What feedback do you have on our Office Hours?
How are we doing?
What works well, what doesn’t?
More or less structure?
Michael

15. THANK YOU!
Michael
Please don’t hesitate to share your thoughts with us in the chat room or by sending your comments to Michael –

16. 212-417-4730 NationalQualityCenter.org Info@NationalQualityCenter.org16