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Background As people with HIV are living longer, focusing quality improvement (QI) initiatives on health maintenance and comprehensive patient-centered care is essential. This QI study evaluated chart-document performance in selected HIV care practices across the United States. Methods Participants were randomly selected from 11 Ryan White-funded HIV clinics in community (n = 7), hospital (n = 3), and academic (n = 1) settings. At baseline, 200 consecutive charts (~20 per clinic) were reviewed for documentation of guideline-directed practices. Clinic teams participated in audit-feedback interventions to develop improvement plans. Three months later, consecutive charts were reviewed according to baseline methods. Chi-square tests were conducted to analyze pre- and post-intervention differences. Results Significant improvements were seen in sexually transmitted infection (STI) screening, and patient counseling on sexual risk, pre-exposure prophylaxis (PrEP), and antiretroviral therapy (ART). Documentation of several health maintenance measures improved significantly. Conclusion Audit-feedback of QI measures improved performance. This approach can inform future QI initiatives.Table: HIV Patient Characteristics and Percentages of Charts Documented for Quality Measures Baseline (n = 200) Post-Intervention (n = 120) P-value Demographic characteristicsa Median years of age 51 40 <0.001 Median years since HIV diagnosis 18 12 <0.001 % female/male/transgender 24/75/1 16/84/0 0.054 Sexual Health Assessment and HIV Prevention STI screening 43 64 <0.001 Counseling on sexual risk 22 48 <0.001 Counseling on PrEP for sexual partners 11 23 0.003 Sexual partners prescribed PrEP 9 15 0.100 Health Maintenance Assessment Glucose 78 91 0.003 Transaminases 77 92 0.001 Cardiovascular risk calculation 71 74 0.541 Lipid profile 59 64 0.359 25OH Vitamin D level 16 27 0.021 Bone densitometry for patients >50 years 7 5 0.299 Creatinine clearance 15 58 <0.001 Shared Decision-Making Patient counseling on ART risks and benefits 53 66 0.056 Understanding ART 33 69 <0.001 Exploring patients’ ART concerns 31 46 0.008 Opportunities for patients to ask questions 51 82 <0.001 aAnalyses for continuous and categorical variables based on Mann–Whitney U test and chi-square test, respectively Disclosures C. Brinson, Gilead: Investigator, Scientific Advisor and Speaker’s Bureau, Research support and Speaker honorarium. Theratech: Investigator, Research support. BMS: Investigator, Research support. SlieaGen: Investigator, Research support. GSK ViiV: Consultant, Investigator and Scientific Advisor, Consulting fee, Research support and Speaker honorarium. Daiichi Sankyo: Sub Investigator, Research support. Novo Nordisk: Investigator, Research support. Sanofi: Investigator, Research support. Watson: Investigator, Research support. Salix: Investigator, Research support. Janssen: Investigator, Research support. Roche: Investigator, Research support. Colucid: Investigator, Research support. Eisai: Investigator, Research support. Shionogi: Investigator, Research support. Elcelyx: Investigator, Research support. Sangamo: Sub Investigator, Research support. C. Hicks, ViiV Healthcare: Employee, Salary. P. Shalit, Gilead: Consultant, Investigator and Speaker’s Bureau, Consulting fee, Research support and Speaker honorarium. Viiv: Consultant and Speaker’s Bureau, Consulting fee and Speaker honorarium. Janssen: Consultant, Investigator and Speaker’s Bureau, Research support and Speaker honorarium. Merck: Speaker’s Bureau, Speaker honorarium. W. D. Hardy, Gilead Sciences: Consultant and Investigator, Consulting fee and Research support. ViiV Healthcare: Consultant and Investigator, Consulting fee and Research support. Amgen: Investigator, Research support. Janssen: Investigator, Research support. Merck: Investigator, Research support. J. Carter, PRIME Education, LLC: Employee, Salary. L. Simone, PRIME Education, LLC: Employee, Salary. T. Sapir, PRIME Education, LLC: Employee, Salary. Gilead Sciences Inc.: Independent medical education provider, Educational grant.

1905. Real-World Insights into Quality Improvement across 11 HIV Clinics in the United States