Quality of comprehensive HIV care in underserved communities: does clinical training lead to improvement.
The AIDS Education and Training Centers National Evaluation Center led collaborative research to evaluate whether Minority AIDS Initiative (MAI)-funded clinical training changes clinical practice. Chart abstraction and feedback (34 clinics; n = 530) were used to assess adherence to clinical practice guidelines, identify training needs, and assess change in clinical practice (14 clinics, n = 271). Generalized estimating equations were used to account for repeated measures within each clinic. At baseline, clinics displayed 49% (95% confidence interval [CI] = 44-53) adherence to clinical practice guidelines. After feedback associated with the baseline chart review and subsequent implementation of MAI-funded clinical training, an 11% increase (95% CI = 7-16) in adherence to clinical practice guidelines was observed. MAI-funded clinical training was associated with increased adherence to clinical practice guidelines for HIV care. Chart abstraction is useful to assess clinical practice, facilitate conversations about quality improvement, and evaluate the effectiveness of clinical training.
AIDS Education and Training Centers National Evaluation Center, Center for AIDS Prevention Studies, University of California-San Francisco, CA 94105, USA. starley.shade@ucsf.edu
Starley B
SB
Shade
Nathan
N
Sackett
Kevin
K
Khamarko
Kimberly A
KA
Koester
Jennifer
J
Bie
Jay
J
Newberry
Jeffrey
J
Beal
Rebecca
R
Culyba
Kathleen
K
Jacobson
Anna
A
Kinder
John
J
Nusser
Janet J
JJ
Myers
D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control; D044966:Anti-Retroviral Agents / Q000008:administration & dosage; D003191:Comprehensive Health Care / Q000458:organization & administration*; D019983:Guideline Adherence / Q000458:organization & administration*; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000628:therapy*; D006403:Hematologic Tests; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration; D008507:Medically Underserved Area; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D011787:Quality of Health Care / Q000458:organization & administration*
D044966:Anti-Retroviral Agents