Organization of Health Care:
Make Improving Chronic Care a Part of the Organization’s Vision, Mission, Goals, Performance Improvement, and Business Plans
- Link HIV/AIDS disease care improvement, measures, and outcomes to the strategic business plan.
- Gain the senior leader’s interest with reports and feedback. Provide senior leaders with data about the benefits of the initiative, including better results on patient satisfaction surveys and improved patient outcomes.
- Have the team leader or physician champion regularly report progress and results to the Board.
- Place storyboards in places visible to staff and patients.
- Post senior leader report/graphs so staff can review.
- Ensure that the business plan acknowledges the way the organization fits in with other players in the health care system (e.g., accreditation and government organizations such as JCAHO, Medicaid, Medicare).
- Overcome resistance or stigma associated with HIV/AIDS disease care. Include HIV as one of the chronic diseases treated at the health center or clinic (if integrated care).
- Ensure that HIV/AIDS disease care is specifically mentioned in the mission statement and business plan of the organization.
- Discuss with senior leaders the direct impact that improved outcomes have on the organization.
- Emphasize the importance of quality improvement in securing and maintaining grant support. Provide references of other senior leaders who have undertaken the same effort.
- Assist senior leaders in determining the "value" of improving HIV/AIDS disease care (e.g., give examples of quality improvement activities for accreditation or Primary Care Effectiveness Review, increased productivity/efficiency, and access to community linkages that can provide needed services and resources).
- Provide clinical vignettes illustrating outcomes and costs attributable to HIV discrimination. Stress volume of HIV/AIDS care at your site.
- Make a standing monthly appointment with the senior leader and team or team leader to discuss the report to the senior leader.
- Provide the report to the senior leader two or three days prior to the meeting to allow for review time and to remind the leader of the appointment.
- Use the Clinical Information System to collect data about cost and outcomes.
- Understand the data! Know what the issues/barriers are, and present them in an objective manner that invites the senior leader to contribute.
- Keep it simple! Provide a simple, straightforward report that everyone can understand. Avoid overly complex technical or clinical terminology.
- Provide patients’ own words or reactions whenever possible, or discuss provider satisfaction.
- Provide printed reports and use overhead graphs, if possible.
- Present outcomes to the Board of Directors and give the Board a list of barriers to progress — e.g., lack of computers, VCRs and training videotapes, transportation, equipment needs (such as medication reminder systems), patient and family understanding of the disease, and resource development — and seek their help in overcoming the barriers.
- Display a sign that states, "For further information, contact xxxxx."
- Promote improvement activities on the waiting room bulletin board or in newsletter.
- Assign a team member to post changes monthly.
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