AETC Quality Management Initiative

Date of Report: 07/2005
Source: Pennsylvania/MidAtlantic AETC

Since members of the Pennsylvania/ MidAtlantic AETC (PA/MA AETC) participated in HRSA's Institute for Health Care Improvement (IHI) training in June 2003, the AETC has incorporated the PDSA (Plan-Do-Study-Act) Improvement Model into its ongoing activities.

Consortium-Wide CQI

A major focus has been the continued maintenance of the local performance site (LPS) "training performance tracking system" which is based on the goals and objectives set forth in the workplan. This system provides the LPSs with up-to-date information on number of programs, trainees, and feedback on meeting goals and objectives. This approach to Continuous Quality Improvement (CQI) has offered a distinct advantage to LPSs, as they are given regular feedback about performance. For the past three years, the consortium headquarters has expanded the internal quality assurance process by providing and conducting the following:

	Review of training activities at quarterly consortium partners meetings
	Posting of data from each LPS on a secure section of the PA/MA AETC website
	Follow-up initiated for Level IV clinical consultation using standardized, tested, and published instruments (1)
	Follow-up continued for Level III clinical training activities using standardized, tested instruments.

In addition, the follow-up of Level III and Level IV trainees has generated information on the impact of these advanced levels of training and demonstrated the following outcomes:

	Positive impact of training programs on clinician practices
	Positive reinforcement for LPSs for their intensive work in providing advanced clinical trainings
	Increased number of referrals for participants in clinical trainings
	Increased number of requests for additional on-site clinical capacity building training programs

LPS Focused CQI

Each LPS has been involved in conducting its own CQI activities. This model has been integrated into the day-to-day operation of the AETC. LPSs within the PA/MA AETC have utilized the PDSA Improvement Model on a range of LPS site issues and in their work with the HIV community, including: the expansion of medical services, treatment issues of specific populations, and training.

The PA/MidAtlantic PDSA objectives and outcomes from the IHI Framework for Excellence (http://www.aidsetc.org/doc/ p05-in/FFE_matrix.doc) can be outlined in four major areas of enhanced focus:

	Internal AETC performance improvement that assists LPSs in meeting goals and objectives.
	Focused areas of program implementation targeted for improvement by individual LPSs (e.g., improvement in marketing of programs).
	Externally focused CQI that is aimed at capacity building at specific clinical sites within the region (e.g., conducting CQI planning at Title III clinics).
	Development of CQI projects that were initiated by the identification of gaps in services, resources, or information (e.g., secondary prevention pocket guides, rapid testing guides).

1 Frank, L., Day, R. Clinical Consultation of the AIDS Education & Training Center: Outcomes of Clinical Capacity Building, HIV/AIDS & Social Work, in press.