HIVQUAL is a HRSA-sponsored national project to build capacity and capability among Ryan White HIV/AIDS Program Part C and Part D grantees to sustain quality improvement. Participation is encouraged, although it is not required.

Built upon a model of quality improvement consultation that was developed in New York State, the goal of HIVQUAL is to improve the quality of care delivered to persons living with HIV. A software program has been developed through HIVQUAL to facilitate measurement of quality. The model is based on several key principals:

• Development of infrastructure for systematically initiating and overseeing quality initiatives
• Measurement of clinical indicators that are based upon clinical practice guidelines
• Use of aggregate data to evaluate performance
• Provision of on-site QI consultations and coaching
• Facilitated QI project development using multidisciplinary teams
• Integration of QI into ongoing planning and work
• Strong patient focus
• Leadership commitment and involvement

Participants are coached to develop specific skills in measurement, sampling, identifying opportunities for improvement and conducting projects to improve performance. Once these skills are learned, they can easily be applied to measure other indicators and to other programs in the organization.

HIVQUAL National Core Indicators
Quality indicators currently measured in the National HIVQUAL Project are:

• Clinical Visits
• HIV Specialist Care
• ARV Therapy Management
• Adherence Assessment
• HIV Monitoring
• Lipid Screening
• Gynecology Care
• PCP Prophylaxis
• STD Management
• TB Screening
• Hepatitis C (HCV) Screening (pilot)
• Dental Care
• Substance Use Screening
• Tobacco Use Screening
• Mental Health Screening
• Prevention Education
• Baseline Resistance Test (pilot)
• Anorectal Exam and Anal Pap Smear (pilot)
• Health Literacy Screening (pilot)

Optional indicators for the National HIVQUAL Project are:

• MAC Prophylaxis
• Pneumococcal Vaccination
• Basic Patient Education
• Ophthalmologic Care
• Colonoscopy

Performance data on these indicators are submitted to the HIVQUAL Project and are compiled into aggregate reports and comparative tables for participants and HRSA.

HIVQUAL Software
The Project offers, at no cost, HIVQUAL software designed to facilitate monitoring of clinical care. This software includes indicators based on clinical practice guidelines developed by the New York State Department of Health AIDS Institute, its expert advisory committees, and the National HIVQUAL Clinical Advisory Committee.

The HIVQUAL software has the capacity to easily import and export data. HIVQUAL software is not a clinical tracking program for all patients in the clinic.

HIVQUAL software offers a simple vehicle for the rapid generation of reports that monitor clinical performance for those patients entered into the database. It will also analyze data for different subpopulation groups, including age, gender, viral load, race/ethnicity and exposure categories, CD4 count and clinic site.

The HIVQUAL Project is sponsored by HRSA’s HIV/AIDS Bureau, Division of Community Based Programs, which funds the New York State Department of Health AIDS Institute. For more information, contact:

Tracy Matthews, Division of Community Based Programs, HIV/AIDS Bureau
Tmatthews@hrsa.gov