301971
EMERGENCY ROOM INTEGRATED ROUTINE HIV SREENING: An innovative way to reach the major drivers of the epidemic—the undiagnosed
Undiagnosed infections remain a major driving force of the HIV epidemic in the United States integrated routine HIV screening in an emergency department (ED) is an innovative approach with great promise to early diagnosis and treatment, which can lead to suppressed viral loads and decreased transmission.
Description:
Routine HIV screening was provided to consenting individuals 15-65 years of age receiving treatment in the ED at the point of triage. Results were given prior to discharge, and linkage to care appointments were scheduled for individuals found to be reactive within 2 days of the confirmed Western Blot results.
Lessons Learned:
Approximately 5,748 people were screened in the ED (an 86% acceptance rate), beginning April 1, 2013. Eleven individuals were confirmed reactive (greater than 0.1% seropositivity rate), and 100% of the confirmed cases were linked to care. About 98% of these individuals had 2 documented visits in the electronic medical records (EMR) within 6 months, and 80% of these individuals had a CD4 count in their EMR within 30 days. Greater than 90% of these individuals had 3 or more visits to the ED within 12 months prior to the integration of the routine screening project. "Impact Stories" were essential for key-stake holders and staff members to clearly define ownership of the project intergration and successfully meet process indicators for quality assurance.
Recommendation:
Integrated routine HIV screening in an ED is an innovative way to reach the major drivers of the epidemic—the undiagnosed, and should be replicated in many more ED’s.
Learning Areas:
Administer health education strategies, interventions and programsLearning Objectives:
List 2 indicators of a successful linkage to care visit.
Differentiate between linkage to care and retention in care.
Idendify a quality assurance measure for missed opportunities to screening.
Keyword(s): Emergency Medical Services, HIV Interventions
Qualified on the content I am responsible for because: I have contributed to the development of HIV prevention strageties for the emergency department as a Certified Health Counselor.
Any relevant financial relationships? Yes
| Name of Organization | Clinical/Research Area | Type of relationship |
|---|---|---|
| Advocate Trinity Hospital | HIV Prevention-Clinical | Employment (includes retainer) |
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.