Clifford Sharp

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2. ISSUE: HIV-infected women have increased rates of HPV and cervical dysplasia, which if left undetected, can rapidly progress to cervical cancer.

1. Pelvic exams (PE) with PAP smears are standard clinical practice, yet are provided inconsistently warranting implementation of a statewide performance improvement campaign.
2. PROJECT: The NYSDOH/AI's Continuous Quality Improvement (CQI) Program conducts reviews based on quality indicators linked to clinical care outcomes at facilities providing HIV care.
3. Performance data on the provision of PEs have remained between 66% and 79% over the last 5 years.
4. To improve PE performance, a campaign launched in 1997 will: 1) identify correlations between service delivery models and PE performance, 2) determine and disseminate examples of best practices, 3) support use of CQI methods by providers through free consultation services and QI software, and 4) publicly release facility-specific performance data.

RESULTS: Annual pelvic/PAP exam performance: TABULAR DATA, SEE ABSTRACT VOLUME. PE data through 3/98 and broken down by facility type (hospitals, community health centers, drug treatment programs), exposure category (IVDU, sexual, other), and geographical location (urban, rural), to be presented at Conference along with results regarding correlations between service delivery models and pelvic exam performance. LESSONS LEARNED: State health departments may play an important role in promoting improved pelvic exam performance by encouraging use of effective service delivery models, engendering competition through public release of data, supporting the use of CQI methods by providers, and promoting innovative approaches related to the provision of GYN care..