Evidence of Success - National Minority AETC

National Minority AETC

Established in 1999, the National Minority AETC (NMAETC) mission is to decrease the disparities in the health outcomes of minority clients with HIV/AIDS by making an impact on the availability and quality of health care services. To that end, NMAETC seeks to increase (1) the core competence of organizations and providers, (2) the number and types of available services, (3) the number of qualified HIV specialists, and (4) the number of clients who access and remain in care. This is achieved through a collaborative network of Historically Black Colleges and Universities (HBCUs), Hispanic Serving Institutions (HSIs), Native American Institutions, Community Based Organizations (CBOs), national organizations that represent minority health care professionals, and the regional AETCs.

NMAETC, through its Capacity Building Interventions, assists organizations in facilitating sustainable changes in order to improve patient outcomes. These interventions focus on clinical delivery improvements and administrative support systems such as financial management and clinical information systems.

Additionally, the NMAETC has been charged with developing strategies to increase the cultural competency of HIV care providers, recognizing that patient outcomes can be influenced by their relationships with providers which are frequently influenced by cultural perspectives.

Illustration: Improving Clinical Outcomes Through Capacity Development in Minority HIV Clinics

One Latino clinic in an urban center received additional RWCA Title III funding to provide primary care services to 100 HIV-infected clients. The clinic had a 30 year history of providing mental health care to Hispanic clients. The clinic had a Medical Director with a background in Psychiatry. He supervised a group of healthcare providers with varied training backgrounds who provided the care in the clinic. The Medical Director, recognizing the inexperience of his providers, contacted the NMAETC to assist in developing and implementing a change plan with their clinic. After conducting a thorough needs assessment, the NMAETC and the clinic determined that organizational change was needed in clinical delivery, data management, financial management, and continuous quality improvement. Table 2 shows the results of a chart review process that was initiated prior to the intervention and six months following the change intervention.

Table 2 - Changes in Selected Clinical Quality-of-Care Indicators Following a Capacity Building Intervention Clinical Indicator Baseline Performance 6-month Follow-up CD4 count monitoring 42% 67% Viral load monitoring 33% 60% PCP prophylaxis 40% 70% Antiretroviral therapy documented 25% 60% HIV patient education documented 8% 20% Adherence review documented 8% 20% PPD 42% 20% Syphilis screening 67% 73% Hepatitis C screening 67% 47% Pneumococcal vaccine 0% 6% Annual dental examination 0% 6% Annual mental health exam 83% 80% Substance abuse counseling 50% 80%

*Percentages reflect the number of charts positive for the indicator out of the total number of charts reviewed The table demonstrates positive change in some clinical markers, such as the monitoring of CD4 cell counts, viral loads and improvements in patient education.

Outcomes

Immediate/Short-term:

	Identified training needs through a needs assessment.

Mid-term/Long-term:

	Realized organizational change in clinical delivery, data management, financial management and continuous quality improvement.
	Quality of care improved.