Clinic-Based Surveillance-Informed Intervention

Priority Population
General Population
Setting
Ryan White HIV/AIDS Program Clinic
Location
Seattle-King County, WA
Intervention Focus
Re-engagement and Retention
Study Period
2012- ongoing

Summary

The Clinic-Based Surveillance-Informed (CBSI) intervention combines clinic and health department surveillance data to identify people with HIV who are out of care and re-engage and retain them in HIV care.

Download the Implementation Guide

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Download the Intervention Summary

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Intervention Outcomes

In the original study, the time to relinkage was shorter among clients in the intervention cohort and a greater proportion was relinked to care (15% vs. 10%).

The second iteration of the intervention showed significant improvements in viral suppression outcomes pre- and post-intervention (from 20% to 82%).

Intervention Components

Assess Staff Resources and Gaps
Explore Existing or New Data Infrastructure
Engage Stakeholders
Generate a Local “Out-of-Care” Definition
Create a Client List
Decide on Data-Sharing Methods
Prioritize Client List
Designate Linkage Specialist
Establish a Communication Protocol
Relink and Retain Clients

Cost Analysis

The Clinic-Based Surveillance-Informed intervention cost analysis can be found here. You can also use the CIE Cost Calculator to create an estimate for implementing the intervention at your organization.

Challenges and Solutions

Challenge: Barriers to Care
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Solution:

Consider offering incentives and connecting with local service agencies to address barriers to care.

Challenge: Lack of Referrals
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Solution:

Educate doctors about the intervention to facilitate referrals.

Challenge: Lack of Administrative Support
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Solution:

Seek ways to sustain linkage activities to ensure active remains an organizational priority.

Challenge: Data Management
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Solution:

Use a database that allows staff to gather, extract, and analyze client-level data.

Challenge: Data-Sharing Complications
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Solution:

Improve the data-sharing process by gathering information about current clinic policies and lessons learned from other interventions.

Challenge: Delayed Data Sharing
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Solution:

By improving the timeliness of data sharing, organizations can ensure that they have the most up-to-date client information, which can facilitate prompt relinkage effort.

Challenge: Undefined Staff Roles
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Solution:

Clearly convey roles and responsibilities and how these may sometimes overlap.

Challenge: Staff Burnout
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Solution:

Find ways to increase staff morale and highlight their efforts to connect people with HIV to care. Conduct consistent check-ins with staff to address barriers in real time.

Challenge: Losing Sight of Long-Term Goals
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Solution:

Focus on sustained engagement in care as the goal rather than relinkage. The linkage specialist can work with providers to identify barriers to sustained engagement in care so that they can address the barriers with clients.

Publications

Outcomes of a clinic-based surveillance-informed intervention to relink patients to HIV care
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HIV provider and patient perspectives on the development of a health department “Data to Care” program: A qualitative study
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HIV care for patients with complex needs: A controlled evaluation of a walk-in, incentivized care model
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The Max Clinic: Medical care designed to engage the hardest-to-reach persons living with HIV in Seattle and King County, Washington
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Potential impact of integrating HIV surveillance and clinic data on retention-in-care estimates and re-engagement efforts
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Setting standards and an evaluation framework for Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome surveillance
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The impact of retention in early HIV medical care on viro-immunological parameters and survival: A statewide study
View Here

Resources

Tips for Implementing the Clinic-based, Surveillence Informed (CBSI) Intervention
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Rapid Start Leads to Sustained Viral Suppression in Young People in the South – CROI Poster
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Clinic-Based Surveillance-Informed

Summary

Download the Implementation Guide

Download the Intervention Summary

Intervention Outcomes

Intervention Components

Cost Analysis

Challenges and Solutions

Challenge: Barriers to Care
Click for the solution

Solution:

Challenge: Lack of Referrals
Click for the solution

Solution:

Challenge: Lack of Administrative Support
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Solution:

Challenge: Data Management
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Solution:

Challenge: Data-Sharing Complications
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Solution:

Challenge: Delayed Data Sharing
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Solution:

Challenge: Undefined Staff Roles
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Solution:

Challenge: Staff Burnout
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Solution:

Challenge: Losing Sight of Long-Term Goals
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Solution:

Publications

Resources

Trainings

Videos

Clinic-Based Surveillance-Informed

Summary

Download the Implementation Guide

Download the Intervention Summary

Intervention Outcomes

Intervention Components

Cost Analysis

Challenges and Solutions

Challenge: Barriers to Care Click for the solution

Solution:

Challenge: Lack of Referrals Click for the solution

Solution:

Challenge: Lack of Administrative Support Click for the solution

Solution:

Challenge: Data Management Click for the solution

Solution:

Challenge: Data-Sharing Complications Click for the solution

Solution:

Challenge: Delayed Data Sharing Click for the solution

Solution:

Challenge: Undefined Staff Roles Click for the solution

Solution:

Challenge: Staff Burnout Click for the solution

Solution:

Challenge: Losing Sight of Long-Term Goals Click for the solution

Solution:

Publications

Resources

Trainings

Videos

Challenge: Barriers to Care
Click for the solution

Challenge: Lack of Referrals
Click for the solution

Challenge: Lack of Administrative Support
Click for the solution

Challenge: Data Management
Click for the solution

Challenge: Data-Sharing Complications
Click for the solution

Challenge: Delayed Data Sharing
Click for the solution

Challenge: Undefined Staff Roles
Click for the solution

Challenge: Staff Burnout
Click for the solution

Challenge: Losing Sight of Long-Term Goals
Click for the solution