Quality Profile: GoCare in Monroe, Louisiana

National Quality Center

From the National Quality Center (now called CQII), from an ongoing series of profiles of activities and insights from Ryan White HIV/AIDS Program agencies implementing clinical quality management.

When it became a [Ryan White HIV/AIDS Program] Part C recipient in 2001, GoCare in Monroe, Louisiana subcontracted HIV outpatient ambulatory health services to a local hospital. When the hospital left the partnership in 2015, GoCare decided to take on the provision of HIV outpatient ambulatory health services. While there were some growing pains, today GoCare provides HIV outpatient ambulatory health services to about 350 consumers.

Since 2015, GoCare reached out to NQC for technical assistance implementing quality improvement activities. GoCare performed an organizational assessment of their quality management program with their NQC coach. They also worked diligently on a revised quality management plan.  GoCare recognized the need to bolster their quality management infrastructure and formed a quality committee that was interdisciplinary and also included consumers.

"Early on, an [HRSA] HIV/AIDS Bureau site visit found that we had numerous deficiencies in our efforts to implement a quality improvement program. Now there is more emphasis on quality...and we have a structure in place." Richard Womack, GoCare's Executive Director

GoCare has also seen successes in the last two years. The rate of viral suppression is now at 78 percent, having improved by several points. They achieved this by the careful analysis of their data and then ensuring that all staff were involved in helping patients stay compliant with their medications and encouraging them to stay in care by reaching out to patients who do not always make their appointments.  The goal is a viral suppression rate of 85 percent. New performance measures added for 2017-2018 are oral health and syphilis screening-which is a priority given the high rates in Louisiana.

Richard has seen staff embrace quality. Many staff are regular participants in NQC's webinars and there are plans to have staff complete Quality Academy tutorials. Quality improvement has been integrated into the organization's culture and staff now recognize the significance and have seen how it benefits both the organization and consumers. GoCare is also participating in the end+disparities Learning Exchange, which focuses on four vulnerable populations.

While the last two years have been a lot of work for GoCare's staff, Richard emphasizes they are very interested in the process and the outcomes.