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In+Care - Improving Viral Load Suppression A Quality Improvement Project AIDS Activities Office Quality Improvement Team  Carlos Castillo, RN  Roselen.

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Presentation on theme: "In+Care - Improving Viral Load Suppression A Quality Improvement Project AIDS Activities Office Quality Improvement Team  Carlos Castillo, RN  Roselen."— Presentation transcript:

1 In+Care - Improving Viral Load Suppression A Quality Improvement Project AIDS Activities Office Quality Improvement Team  Carlos Castillo, RN  Roselen Villalba, RN  Lynn Nagel, BSEd, CQI Coordinator  Stephen D Sabo, AA, Data Coordinator  Length of study: February 2012 – January 2013  Focus on clients in the AAO Adherence Program

2 Background Information/Rationale for QI Project Clients missing doses of medication can lead to resistance Lowering of one’s viral load shows responding to treatment and following medication regiment Clients in the adherence education program will show a increase in viral load suppression. Overall in 2007, 64% of AAO clients had a suppressed viral load. In 2011, the percentage was 74.

3 Performance Measure In+Care 4: Percentage of clients with HIV infection whose last viral load in the measurement year is less than 200 copies

4 In Care -Baseline Data VL Suppression – Below 200  All AAO clients  Year 2011 – 528/711 = 74%  Clients in Adherence program  Year 2011 – 118/194 = 60%  Clients in adherence program  November 1, 2011 – January 31, 2012 = 84 clients were enrolled in the adherence program. 56% (47/84) had a viral load of <200  Clients are referred to adherence program by physicians

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7 Cause Diagram

8 PDSA – Plan/Do (First Quarter) Create flow diagram and review adherence process Create cause diagram and review with team Classification of clients in program, long term / short term Frequent adherence appointments will be scheduled as needed Frequent follow up phone calls Review list of clients on adherence & remove those that no longer need to be in program, lost to follow-up, moved, etc and removed these clients from active list Run monthly reports with VL’s for adherence nurses to monitor Interventions specific to individual clients needs that are in the Adherence Program  Will help pay co-pays for clients  Provide transportation assistance – bus passes or taxi vouchers

9 PSDA - Study/Results (First Quarter) All AAO clients Overall there was an increase in the number of clients with a viral load <200 to 77% (510/727) – April 30, 2012  For %(528/711) of clients had a viral load <200  Incentives and perseverance on part of the adherence nurses have shown an increase in the number of clients with a viral load <200.

10 PSDA - Study/Results (First Quarter)  Clients in Adherence Program – Feb 1 – April 30, 2012  92 clients were enrolled in the adherence program. 62% (57/92) had a viral load of < clients received transportation vouchers. 60% (6/10) had a viral load of < clients received co-pay assistance. 61% (14/23) had a viral load of <200 2 clients received both transportation & co-pay assistance. 0% (0/2) had a viral load of < clients did not receive any incentives. 61% (35/57) had a viral load of <200

11 PSDA - Study/Results (First Quarter)  Months in Program VL <200  New – 2 months 23% (21/92)  3 months – 5 months 24% (22/92)  > 6 months 15% (14/92) VL > 200  New – 2 months 20% (18/92)  3 months – 5 months 11% (10/92)  > 6 months 8% (7/92)

12 PDSA – Act (Second Quarter) Next step: continue with paying co-pays, transportation needs, frequent visits & phone calls Design a bulletin board for visual reinforcement in the clinic on the importance of medication adherence Closely monitor “long term” clients for any adherence issues Compare 3 month data with 6 month data looking for trends


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