Center for Program Development, Implementation, Research and Evaluation (CPDIRE)

Comprised organizationally of the Office of Program Evaluation and Research and the Center for Quality Improvement and Innovation, CPDIRE was established in 2019 and works with programs throughout the AI to:

  • Direct the AIDS Institute Programming Group
  • Evaluate existing AI programs
  • Develop new programming to support ETE and 2020 and beyond initiatives
  • Support internal QI efforts
  • Compete for new grant opportunities
  • Grow academic partnerships
  • Operate and expand national training centers
  • Disseminate best practice through internal reports, presentations and publications in peer reviewed journals

CPDIRE coordinates research at the AIDS Institute, serving as an internal resource for staff in research design, implementation, analysis, manuscript preparation and human subjects protocol development.  CPDIRE works with researchers and programs to execute research and evaluation prioritized in the AIDS Institute Research Agenda.  CPDIRE works to ensure that AI research Is purposeful and inclusive, (i.e., conducted in cross-unit teams including program and research staff), translates into actionable programming, and is disseminated to broader audiences. 

CPDIRE serves as a liaison to the Center for Collaborative HIV Research in Practice and Policy (CCHRPP).  CCHRPP leverages unique partnerships to expand collaborations to address social justice and public health challenges of persons at risk for or living with HIV and related diseases.  CPDIRE works to advance CCHRPP goals and objectives, including conducting research that translates into policies, programs, and practices; creating academic programs and internships that prepare students for careers in public health; providing continuing education for professionals; hosting seminars and partnering with collaborating institutions to share research that addresses social justice and public health challenges of persons at risk for or living with HIV and related diseases; and establishing thought leadership to see to completion of New York’s aggressive “End the Epidemic” initiatives for HIV and hepatitis C.  

Contact:

James M. Tesoriero, PhD
Center for Program Development, Implementation,
Research and Evaluation
(518) 474-7238
james.tesoriero@health.ny.gov

Office of Program Evaluation and Research

The Office of Program Evaluation and Research (OPER) conducts comprehensive, coordinated, and innovative program evaluation and research in multiple AIDS Institute program areas, with the aim to enhance the quality of HIV/AIDS, STIs, hepatitis C, and opioid overdose prevention services, clinical care, and service delivery systems in New York State.

Working alongside AIDS Institute programs, OPER develops evaluation protocols, implements data collection, performs data analysis, and presents findings for a variety of initiatives and projects.  In addition to examining the extent to which program initiatives are achieving their stated objectives, factors associated with successes and barriers are identified, and recommendations are made to further improve program outcomes.

OPER provides technical assistance to AIDS Institute programs that collect and maintain their own program data. Assistance is provided with grant applications, Institutional Review Board (IRB) applications, evaluation planning, sample selection, development of data collection tools, maintenance of databases, data analysis training, and manuscript development.

OPER produces informational products using a wide variety of existing and prospectively collected data in support of AIDS Institute program planning and policy development. OPER also collects and conducts reviews of scientific and professional literature for AIDS Institute programs. The AIDS Institute Literature Update on the most recent research pertaining to HIV/AIDS, STIs, hepatitis, and drug user health is compiled and distributed to subscribers on a bi-monthly basis.  The AIDS Institute News Brief is published weekly to provide brief abstracts of media reports on HIV/AIDS, STIs, tuberculosis, hepatitis, drug user health, and related subjects.

OPER collaborates with AIDS Institute programs and external partners on presentations for professional conferences and manuscripts for journal publication.

Contact:

Shu-Yin John Leung, M.A.
Director, Office of Program Evaluation and Research
(518) 402-6814
shu-yin.leung@health.ny.gov

Center for Quality Improvement and Innovation (CQII)

The New York State Department of Health AIDS Institute is funded by the Health Resources and Services Administration (HRSA) HIV/AIDS Bureau to develop and implement the HRSA Ryan White HIV/AIDS Center for Quality Improvement & Innovation (CQII). CQII serves as a national resource to provide technical assistance to Ryan White HIV/AIDS Program (RWHAP)-funded recipients and subrecipients to measurably strengthen local clinical quality management programs to impact HIV health outcomes. The AIDS Institute was recently funded in July 2020 to manage CQII, which is now housed at the Center for Program Development, Implementation, Research and Evaluation (CPDIRE), after operating the National Quality Center (NQC) since 2004.

CQII provides four levels of technical assistance to RWHAP recipients and subrecipients:

  • Information Dissemination: monthly newsletters, websites, quality improvement publications and guides, exhibits at HIV or quality improvement conferences, annual awards to highlight quality improvement champions
  • Training and Educational Forums: monthly technical assistance webinars, advanced trainings, online quality improvement tutorials, virtual trainings courses across multiple quality improvement competencies
  • Consultation: on/off-site coaching of recipients and subrecipients to advance their clinical quality management programs and improvement efforts
  • Communities of Learning: implementation of national quality improvement collaboratives to address HIV-related public health priorities

On/off-site technical assistance is delivered across the United States through a nationwide network of expert quality improvement coaches. RWHAP recipients or subrecipients request technical assistance using a standardized Technical Assistance Request Form and submit the completed form to HRSA for their review and approval. The provision of technical assistance allows recipients and subrecipients to be in alignment with Policy Clarification Notice #15-02 issued by HRSA in 2015.

CQII implements multiple face-to-face and virtual training opportunities for HIV providers and people with HIV. The CQII Training-of-Trainers (TOT) Program directly assists HIV providers with building training capacity in quality improvement practice. The Training of Quality Leaders (TQL) Program provides participants with the ability to enhance their own expertise in quality management so they can lead their own local quality improvement efforts. The Training on Coaching Basics (TCB) Program aims to close any educational gaps of quality managers and to increase quality improvement competencies by building the quality improvement capacity of quality leaders to coach other HIV providers on quality improvement. In 2021, CQII launched a virtual quality improvement training program, called Learning Lab, comprised of multiple independent Labs categorized by quality improvement proficiency level. Each Lab consists of six 90-minute virtual sessions over three months and uses a case-based learning approach with real-world HIV examples. In addition, CQII provides training opportunities for people with HIV to actively participate in local and regional quality improvement activities and partner with HIV providers to increase meaningful and comprehensive consumer involvement.

In response to the recognition how difficult it can be to find time to learn about quality improvement, CQII has developed the Quality Academy, an online modular learning program on quality improvement topics, accessible 24/7. Myriad of tutorials explain quality improvement principles and methodologies, provide real world examples from other HIV providers, and describe methods for applying this information to your HIV program. The tutorials span the spectrum of quality management proficiency — from novice to expert — and take about 15-20 minutes each to complete.
 
To foster local communities of learners, CQII launched several cross-state collaboratives, which were modeled on the Institute for Healthcare Improvement’s (IHI) Breakthrough Series. The aims for these initiatives focused on alignment of clinical quality management goals to cooperatively meet the federal legislative mandates and to advance the quality of care for people with HIV within the respective constituencies. Recently, CQII successfully implemented the end+disparities Project Extension for Community Health Outcomes (ECHO) Collaborative to nationally mitigate HIV disparities. This national virtual initiative has been built on the success of past NCQ collaboratives and incorporated the expertise of Project ECHO, housed at the University of New Mexico. The Collaborative has reached 35% of all RWHAP-funded grant recipients that collectively have served 135,000 HIV patients, 1 of every 8 persons with HIV in the United States and demonstrated improved health outcomes and reductions in HIV disparities, moving toward ending the HIV epidemic. The model of utilizing low-cost videoconferencing technologies to create active online communities of learning is well-suited to mitigate other disease-related disparities, nationally and abroad, and will be used by CQII in upcoming collaboratives.

Since 2004, CQII has successfully engaged 91% of all 587 RWHAP recipients; graduated ~1,800 individuals (representing 61% of all recipients) from over 50 three-day QI trainings; provided onsite technical assistance to 40% of recipients; and reached 50% of recipients in collaborative activities.

CQII has recently received funding from the HRSA Global Program Skills Sharing Program to promote the exchange of best practices of RWHAP recipients with those at prioritized PEPFAR-funded countries. CQII staff are currently involved in Uganda by working with 15 HIV ambulatory care programs in three districts and by providing recommendations through in-person site visits. In addition, CQII manages the twice-a-month virtual sessions to further promote bilateral peer exchanges between RWHAP and PEPFAR-funded ambulatory health care facilities.

Contact:

Clemens M. Steinböck, MBA
Director, Center for Quality Improvement and Innovation (CQII)
(212) 417-4730
clemens.steinbock@health.ny.gov

For more information:
http://www.CQII.org
Email: Info@CQII.org

NYLinks

New York Links (NYLinks)

New York Links (NYLinks) began in September of 2011 as a Health Resources and Services Administration (HRSA) funded Special Project of National Significance (SPNS) and is a statewide initiative focusing on improving linkage to care, engagement in care, and viral load suppression for people living with HIV/AIDS (PLWHA).  This is done through the formation of geographically based collaboratives of HIV providers who meet regularly to share improvement work.  NYLinks measures improvement using data that is self-reported, then verified through surveillance.  Improvement is measured organizationally as well as regionally.  Participants in NYLinks receive technical assistance to assist them with their improvement projects.

Mission of NYLinks

NYLinks addresses community needs and statewide priorities through enhanced collaboration and integration of quality improvement methodology among organizations and programs that provide HIV services to decrease gaps in the HIV care continuum as part of the New York State initiative to end AIDS.

Goals of NYLinks

To identify and spread innovative solutions for improving linkage to and engagement in HIV care that support the delivery of routine, timely, and effective care for PLWHA in New York State.  To bridge systemic gaps between HIV related services to achieve better outcomes for PLWHA through improving systems for monitoring, recording, and accessing information about engagement and linkage to HIV care in NYS.

Major Strategies

  • Implementing a community-based response to the HIV epidemic by mobilizing networks of clinical and non-clinical providers, community leaders, and community members living with or affected by HIV/AIDS.
  • Aligning programs, providers and the community to address the Ending the Epidemic goals of New York State through shared, local leadership and with technical support from state and local health departments.
  • Building capacity for quality improvement in the region, identifying and disseminating successful interventions within the continuum of HIV services and sustaining the achieved regional results.
  • Using community level data to link public health strategies with clinic and service level improvement initiatives.

In Plain Language

NYLinks builds regional groups consisting of everyone--public and private--who provide services to HIV-positive individuals.  The purpose of these groups is to share best practices, develop a common culture around improvement, and work, both individually and regionally, to improve linkage to care, engagement in care, and viral load suppression through the use of shared data, competition, networking, and peer learning.

Contact:

Steven Sawicki, MHSA
Program Manager
Office of the Medical Director
(518) 474-3813
steven.sawicki@health.ny.gov

For more information:  http://www.newyorklinks.org

New York State Quality of Care Program

The AIDS Institute is committed to promoting, monitoring, and supporting the quality of HIV clinical services for people with HIV in New York State (NYS).  The Office of the Medical Director (OMD) has provided important leadership in improving HIV care among providers within NYS and nationally.  Integrating performance data to identify and monitor quality of care indicators, establishing effective quality management programs, and engaging consumers in substantive discussion and consensus building have served as a template for programs that have benefitted countless people with HIV worldwide.

The NYS Quality of Care (QOC) Program is committed to ensuring equitable access to HIV care that promotes the health and wellbeing of all people living with HIV (PLWH) in NYS. The QOC Program collects data on the performance of HIV providers, uses these data to identify areas for improvement, and fosters improvement both by supporting improvement activities and by building capacity for quality management.

OMD coordinates the participation of several groups of stakeholders to accomplish these tasks including (1) the HIV QOC Workgroup, an internal workgroup which coordinates the various AIDS Institute quality programs and activities; (2) the HIV QOC Clinical Advisory Committee (QAC), composed of expert HIV providers who advise on the development, implementation, and refinement of the QOC Program; (3) the Joint Consumer Advisory Committee (CAC) and Young Adult Consumer Advisory Committee (YACAC), composed of the individuals representing the diverse communities and regions affected by the HIV epidemic in NYS; and (4) the HIV Clinical Guidelines Program, responsible for clinical guidelines development.

The following quality improvement initiatives are integrated into the QOC Program and are being implemented or continued statewide in 2020:

  • Organizational HIV Treatment Cascade: With the goal of increasing the proportion of PLWH who achieve durable viral suppression, the QOC program has asked clinical HIV providers across NYS to submit organizational treatment cascade data, which identify the proportion of PLWH at each clinic at each stage of the care continuum, from diagnosis through viral suppression. Using an excel template created by the QOC, providers can generate various data visuals to assist in their analysis of outcomes and to develop improvement activities.  These organizational treatment cascade data allow providers to clearly identify gaps along the pathway from linkage and engagement in care to viral suppression and to develop and guide improvement activities that aim to address those gaps. The data, analysis and improvement plan are all submitted using this same template to the QOC program via the Health Commerce System.
  • The program will provide cascade review data for the AIDS Institute’s Health Equity Program and will encourage HIV providers to use their cascade review data to mitigate disparities in health outcomes and increase data driven health equity.
  • In addition to the organizational treatment cascades, additional topic-specific reviews are conducted annually in accordance with identified priority areas.  Areas being considered by the QAC and CAC are HIV and aging, HIV and long-term survivors, Hepatitis C co-infection, and sexual health.
  • The QOC focuses upon stigma reduction and resiliency building.  The program works with the Stigma and Resiliency (STAR) Coalition which includes Columbia University and New York City Department of Health and Mental Hygiene (NYCDOHMH), in identifying effective stigma reduction activities through interviewing HIV care providers.  The QOC Program will support the QAC and CAC in creating a catalogue of stigma reduction activities to be shared with providers throughout the state.
  • A Quality Improvement (QI) curriculum is being developed by the program for training of QI.
  • QOC Program collaborates with clinical and supportive service providers, particularly all Part B recipients, to provide QI coaching and training and to monitor the quality of care.
  • The QOC Program provides QI training for staff of the AIDS Institute.
  • The QOC Program will collaborate with CEI in focusing on viral load suppression (VLS) low performers.
  • The QOC Program will continue a collaboration with NYCDOHMH in providing capacity building opportunities to providers, particularly programs that have been identified as having special challenges such as low VLS rates.
  • The QOC Program, working with NYCDOHMH Clinical Operations and Technical Assistance (COTA) program will develop TA material for HIV providers regarding evaluative frameworks for remote/telehealth HIV care.
  • The QOC Program has established several quality learning networks and NYLinks regional groups aimed at improving the health and well-being of PLWH and ending the epidemic in NYS.

QOC Program Standards outline the expectations for HIV providers in NYS, regardless of their caseload, location, or service delivery model. All HIV ambulatory programs are expected to establish a Quality Management program to assess the extent to which HIV health services provided to patients are consistent with these QOC Program Standards. QOC staff and coaches conduct annual organizational assessments of each HIV ambulatory care program in NYS annually to evaluate, track, and, support adherence to the QOC Program Standards.

In addition, QI Profiles are developed for high priority HIV programs that both receive an organizational assessment and submit their performance data. High priority programs are defined by case load and viral suppression rates. The profiles offer a succinct overview of longitudinal data results, organizational assessment results, and capacity building activities, and suggest opportunities for improvement.

AIDS Institute QI experts provide professional assistance to further strengthen quality management programs in HIV facilities throughout NYS.  They work with provider teams to set priorities for improvement initiatives and develop plans for quality improvement and ongoing internal quality monitoring. AIDS Institute staff and QI coaches provide education focusing on quality improvement methods, assist with the interpretation of data, and promote creative thinking by facility personnel to improve performance. 

Contacts:

Daniel Belanger, LMSW
Director, NYS Quality of Care Program
(212) 417-6131
daniel.belanger@health.ny.gov

For more information:
https://quality.aidsinstituteny.org/

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