HIV quality of care assessment at an academic hospital: outcomes and lessons learned.
Rapid changes in HIV treatment guidelines and antiretroviral therapy drug safety data add to the increasing complexity of caring for HIV-infected patients and amplify the need for continuous quality monitoring. The authors created an electronic HIV database of 642 patients who received care in the infectious disease (ID) and general medicine clinics in their academic center to monitor HIV clinical performance indicators. The main outcome measures of the study include process measures, including a description of how the database was constructed, and clinical outcomes, including HIV-specific quality improvement (QI) measures and primary care (PC) measures. Performance on HIV-specific QI measures was very high, but drug toxicity monitoring and PC-specific QI performance were deficient, particularly among ID specialists. Establishment of HIV QI data benchmarks as well as standards for how data will be measured and collected are needed and are the logical counterpart to treatment guidelines.
Hudson River HealthCare, Peekskill, NY 10566, USA. ckerr@hrhcare.org
Christine A
CA
Kerr
Naama
N
Neeman
Roger B
RB
Davis
Joanne
J
Schulze
Howard
H
Libman
Larry
L
Markson
Mark
M
Aronson
Sigall K
SK
Bell
D000046:Academic Medical Centers / Q000592:standards*; D023241:Antiretroviral Therapy, Highly Active / Q000592:standards; D018791:CD4 Lymphocyte Count / Q000592:standards; D016208:Databases, Factual; D005260:Female; D019983:Guideline Adherence; D015658:HIV Infections / Q000628:therapy*; D006801:Humans; D008297:Male; D010607:Pharmacy Service, Hospital; D011320:Primary Health Care / Q000592:standards; D011785:Quality Assurance, Health Care / Q000379:methods; D058996:Quality Improvement; D019984:Quality Indicators, Health Care