383. A Quality Improvement Project to Increase HIV Testing Among Adults with Infectious Disease Consults at a Large Academic Center
Session: Poster Abstract Session: HIV Epidemiology: Screening and Testing - Outpatient to Inpatient
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • IDSA 2015 QIHIV.pdf (702.9 kB)
  • Background: Fourteen percent of the population infected with HIV is unaware of their diagnosis. In 2013, the USPTF recommended clinicians to screen all patients aged 15 to 65 for HIV. Infectious Disease (ID) physicians are particularly well-suited to recommend HIV testing when appropriate and educate other physicians about the importance of this recommendation.  We are also available to counsel newly diagnosed patients and link them to care. The objective of the study was to increase the percentage of patients receiving an HIV test on our inpatient consult service by at least 15%.

    Methods: We conducted a prospective quality improvement project. We first calculated the baseline proportion of adult patients tested for HIV among admitted patients who received an ID consult from January through June 2014. During the intervention period (July 1 to March 30 2015), written and verbal recommendations for appropriate screening were communicated to the primary teams with our recommendations. 

    Results: We achieved the goal of increasing the proportion of tested patients by a relative 15% from 48.9% at baseline to 56.1%.Baseline data showed that out of 276 consults, 135 patients were tested  and of these 3 (2.2%) represented new diagnoses.  During our intervention period out of 437 consults, 245 were tested  and 3 of these (1.2%) represented a new diagnosis.  

    Conclusion: Despite improving the amount of testing we did not find any additional patients with a new diagnosis, likely due to a brief period of intervention.  Barriers to implementing testing to all patients exist and some are patient factors (refusal) and others are provider factors (not following recommendations provided by the ID physician). Routine HIV testing has been shown to be cost effective and identifying patients early improves survival; links them to care at an earlier stage of the disease; provides access to medications ; and finally, prevents transmission of the virus. Many patients admitted to the hospital have not received routine HIV testing and ID physicians have the opportunity to educate primary providers and increase adherence to this recommendation.

    Claudia Taramona-Espinoza, MD, William Largen, MD, Yumi Oh, MD, Djeunou Tchamba, MD, Cassandra Salgado, MD, MS and Lauren Richey, MD, MPH, Infectious Diseases, Medical University of South Carolina, Charleston, SC

    Disclosures:

    C. Taramona-Espinoza, None

    W. Largen, None

    Y. Oh, None

    D. Tchamba, None

    C. Salgado, None

    L. Richey, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.