1. Dr. Peter Centre Rapid Fire Presentation September 26, 2012

2. Engagement in Care at the Dr. Peter Centre

3. “AHA” Moment At the “Spread Phase” for many of the measures and our data collection tools developed in the Collaborative Collaborative Measures HIV Primary Care Visits Additional DPC Measures ARV Adherence according to Medication Administration Records [MAR] Customized Qualitative Survey: IHI questions fit DPC model Self-reported ARV adherence Client-provider engagement ART uptake among those who unequivocally need it Achieving maximal HIV virologic control Patient experience HIV Viral Load Test

4. “Hmmm” Moment Also had some moments of reflection in the last Action Period −How to sustain the improvements we developed in Dec 2010 - Mar 2012? − How to maintain the accountability structure without monthly reporting, and other STOP projects going on?

5. “Hmmm” Moment Dips in the data — After months of continuous improvement on some measures, we plateaued, and in some cases, we dipped — But, the dips reflect the challenging nature of the clientele — The positive is that now we are measuring the dips

6. “Oh No” Moment Survey fatigue — After surveying our clients 4 times with the same survey in 12 months, clients were not as engaged or interested in completing our survey

7. Moving Ahead The Survey –Changing the survey –Changing the way it’s administered Pilot another engagement measure