Implementing Routine HIV Screening in an Urban Adolescent Population at a General Pediatric Clinic

Jaron Smith, Paul Broker, Melony Chakrabarty, Jason Santiago, Jennifer Farabaugh, Janice Piatt, Kristen Samaddar

Research output: Contribution to journalArticlepeer-review

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 languageEnglish (US)
Pages (from-to)737-741
Number of pages5
JournalJournal of Adolescent Health
Volume68
Issue number4
DOIs
StatePublished - Apr 2021
Externally publishedYes

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

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