Central Implementation Strategies Outperform Local Ones in Improving HIV Testing in Veterans Healthcare Administration Facilities

Abstract

Use of clinical reminders, provider feedback, education and social marketing significantly increased the frequency at which HIV testing is offered and performed in VHA facilities. These findings support a multimodal approach toward achieving the goal of having every American know their HIV status as a matter of routine clinical practice.

Delivering PACT-Principled Care: Are Specialty Care Patients Being Left Behind?

“…These clinics were a convenience sample of sites participating in an HIV testing study. 21 We interviewed clinic staff, including physicians, physician assistants, nurses, social workers, psychologists, psychiatrists, pharmacists and clerks. We sought to interview all staff in the clinic.…”

Factors Underlying Quality Problems with Alcohol Screening Prompted by a Clinical Reminder in Primary Care: A Multi-site Qualitative Study

“…[21][22][23][24]40 Although not without limitation, 41,42 clinical decision support systems have been used to implement evidence-based practices across multiple conditions, [43][44][45][46][47][48][49] and many of these systems are being developed to be shareable across multiple healthcare systems, 50 especially in the U.S. in response to healthcare reform. Findings from the present and prior studies in VA suggest that while VA's alcohol screening clinical reminder has effectively prompted clinical staff to conduct screening and facilitated documentation that screening occurred, 9 it has not facilitated screening in a validated, standardized, reproducible way.…”

Building Strong Research Partnerships Between Public Health and Researchers: A VA Case Study

“…In partnership with Clinical Public Health, HHQUERI demonstrated the effectiveness, 5 acceptability, 6 sustainability, 7 exportability, 8 and implementation costs 9 of the intervention in Southwestern sites in the US, which was eventually translated to other regions of the country, where a significant increase in HIV testing rates was observed. 7,10 Throughout the project, Clinical Public Health actively promoted HIV testing (e.g., provider training, social marketing), and after the initial regional research results, promoted the dissemination of the clinical reminder throughout the VA. HHQUERI assisted in demonstrating the cost-effectiveness of HIV testing, 11 Time Horizons. Researchers are used to a longer process for studying, analyzing, and reshaping ideas for grants.…”