Abstract
Purpose: To increase the rate of routine HIV screening during preventative visits for adolescent patients aged 15 to 21 in a pediatric and adolescent clinic in accordance with national recommendations, which are poorly implemented nationwide. Methods: This was a quality improvement initiative. Four plan-do-study-act (PDSA) cycles were conducted from May 2016 to February 2020. Interventions included education of and reminders for the multidisciplinary team on guidelines and testing, creation of a standardized workflow, introduction of a rapid point-of-care HIV antibody test (POCT), and implementation of an opt-out, medical assistant/nursing-driven protocol for HIV rapid point-of-care testing. The primary outcome measure was the monthly percentage of adolescents screened for HIV during preventative visits. Data is presented in a p-control chart and means were adjusted for special cause variation according to the Institute for Healthcare Improvement guidelines. Results: Rates of routine HIV screening at preventative visits for youth ages 15 to 21 increased from the pre-intervention rate of 5.16% to a final rate of 41.5% over four PDSA cycles. Mean screening rates were adjusted after introducing the HIV POCT (+18.5%) and after implementing the medical assistant/nursing-driven protocol (+17.9%). Conclusions: We successfully increased routine HIV screening rates at preventative visits for adolescents at an urban pediatric and adolescent clinic. This was in large part due to testing with a rapid HIV POCT and a clinic protocol allowing medical assistants and nurses to order the test under a physician's name as part of the intake process. Ours can be a model for other clinics.
Original language | English (US) |
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Pages (from-to) | 737-741 |
Number of pages | 5 |
Journal | Journal of Adolescent Health |
Volume | 68 |
Issue number | 4 |
DOIs | |
State | Published - Apr 2021 |
Externally published | Yes |
Keywords
- Ambulatory clinic
- Point-of-care
- Quality improvement
- Sexually transmitted infection screening
- Youth
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Public Health, Environmental and Occupational Health
- Psychiatry and Mental health