Implementing QI in HIV Clinics to Improve Retention in Care

Amy M. Sitapati, MD


November 29, 2012

In This Article


The promise of an AIDS-free generation has reinvigorated health providers caring for poorly retained patients to improve HIV care delivery. By 2015, the Office of National AIDS Policy aims to increase to 80% the percentage of Ryan White clients who are engaged in care and to reduce HIV-related health disparities by improving care services for all Americans.[1] Yet, the attainment of an AIDS-free generation will require interventions that improve care for persons living with HIV in all healthcare settings where services are delivered. Improvements are needed in clinics across the country to identify and effectively treat the entire HIV population by lowering community viral load, reducing transmission, and ultimately eliminating new HIV cases.

An important starting place for that work is to increase the number of patients who are engaged in continuous high-quality care. HIV care organizations, whether hospitals or clinics, play the leading role in implementing these initiatives to improve the quality of HIV care that focus specifically on retention as part of the national strategy.

Implementation of a successful retention program requires assessing which strengths within the existent structure of the HIV clinic may remove barriers to care and enable the clinic to serve more effectively as a place for continuous comprehensive care, successfully achieving the elements that define a patient-centered medical home.[2] A quick evaluation of personnel and skills, electronic health record functionality, database tracking, and patient motivation may inform the initial strategy. In addition, consideration of the ability to address patients’ everyday needs for transportation, legal assistance, nutrition services, mental health services, case management, substance use treatment, and child care may add depth and essential services to reach the goals of achieving desired health outcomes.