Presentation on theme: "Quality Improvement Team"— Presentation transcript:
1 Quality Improvement Team In+Care - Improving Viral Load Suppression A Quality Improvement Project AIDS Activities OfficeQuality Improvement TeamCarlos Castillo, RNRoselen Villalba, RNLynn Nagel, BSEd, CQI CoordinatorStephen D Sabo, AA, Data CoordinatorLength of study: February 2012 – January 2013Focus on clients in the AAO Adherence Program
2 Background Information/Rationale for QI Project Clients missing doses of medication can lead to resistanceLowering of one’s viral load shows responding to treatment and following medication regimentClients 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 MeasureIn+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 programYear 2011 – 118/194 = 60%Clients in adherence programNovember 1, 2011 – January 31, 2012 = 84 clients were enrolled in the adherence program. 56% (47/84) had a viral load of <200Clients are referred to adherence program by physicians
8 PDSA – Plan/Do (First Quarter) Create flow diagram and review adherence processCreate cause diagram and review with teamClassification of clients in program, long term / short termFrequent adherence appointments will be scheduled as neededFrequent follow up phone callsReview 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 listRun monthly reports with VL’s for adherence nurses to monitorInterventions specific to individual clients needs that are in the Adherence ProgramWill help pay co-pays for clientsProvide transportation assistance – bus passes or taxi vouchers
9 PSDA - Study/Results (First Quarter) All AAO clientsOverall there was an increase in the number of clients with a viral load <200 to 77% (510/727) – April 30, 2012For %(528/711) of clients had a viral load <200Incentives 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, 201292 clients were enrolled in the adherence program. 62% (57/92) had a viral load of <20010 clients received transportation vouchers. 60% (6/10) had a viral load of <20023 clients received co-pay assistance. 61% (14/23) had a viral load of <2002 clients received both transportation & co-pay assistance. 0% (0/2) had a viral load of <20057 clients did not receive any incentives. 61% (35/57) had a viral load of <200
12 PDSA – Act (Second Quarter) Next step: continue with paying co-pays, transportation needs, frequent visits & phone callsDesign a bulletin board for visual reinforcement in the clinic on the importance of medication adherenceClosely monitor “long term” clients for any adherence issuesCompare 3 month data with 6 month data looking for trends