Implementing QI in HIV Clinics to Improve Retention in Care

Amy M. Sitapati, MD

Disclosures

November 29, 2012

In This Article

Steps to Success

Successful implementation of a retention quality project should not require building new systems. Rather, the goal should be to enhance current systems and to reuse existing resources, especially operations and personnel, in a way that helps develop a more structured program focusing on tracking patient retention (Table 2). The team approach to patient-centered health delivery and quality improvement activity positions healthcare providers to address the shortcomings in HIV population health through improved retention in HIV care.

Table 2. Step-wise Process for Implementing a Successful HIV Retention Program

Step 1 Create a registry of active HIV patients in the medical practice
Step 2 Choose the retention measure and calculate and report baseline performance
Step 3 Create policies, procedures, and protocols to implement an active retention program using current knowledge through the assistance of a multidisciplinary team and a quality improvement team
Step 4 Develop an effective tracking retention report using an electronic health record database
Step 6 Start the retention program
Step 7 Use a process model for quality improvement, such as a Plan-Do-Study-Act cycle,[6] consisting of small-scale tests of planned actions followed by assessment and improvement of the initial plan, as well as an HIV-specific quality improvement plan to address unforeseen barriers to effective implementation, including deficiencies in scheduling, access, patient health navigation, and systems
Step 8 Update Step 1, repeat Step 2, refine Step 3, and continue Step 6
Step 9 Report quarterly improvements in retention

Acknowledgement: Dr. Sitapati's patient-centered medical home research is funded by California HIV/AIDS Research Program MH10-UCSD-640.

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