Author: jaustin

Peach County Health Department
Population served: 27,014

Quality Improvement Story Board
Increasing HIV Testing Rates
July 2014

Team Members:
Edye Tillman-Johnson, Kim Warren, Ronnie Boone, Judy Bradshaw, Yvonne Way, Ernestine Taylor,
Bertha Ashley, Joy Knight, and
Gurleen Roberts

Background

4. Identify Potential Solutions

7. Collect and Document Data

Quality Improvement (QI) focuses on improving current processes. The foundation of NCHD’s QI efforts resides on the Plan-Do-Check-Act (PDCA) or Plan-Do-Study-Act (PDSA) cycle. This method is the most widely used, simple approach for quality improvement projects. PDCA and PDSA may be used interchangeably.

Plan
Identify an Opportunity and Plan for Improvement

1. Opportunity/AIM Statement

HIV Testing rates should be around 80%, according to the HIV program coordinator at the NCHD, because this test is a mandatory part of a routine and annual visit.

2. Current Process Map for HIV
Testing

Improve testing rates by:
eliminating unnecessary paperwork/consent forms.
adding an opt-out option and reason for opting out of the HIV test in M&M workflow
possibly condensing workflow screens

5. Develop an Improvement Theory

IF we can condense/remove some of the paperwork, THEN testing rates will increase.
IF we can make M&M more user friendly, THEN we can give nurses credit for productivity for patients that opted-out of the test.

During July 2014, out of 35 eligible visits, 27 HIV tests were done. This results in a testing rate of 77%.

Check/Study
Use Data to Study Results of
the Test

8. Analyze the Effect of the
Intervention

Removing the demographic form increased efficiency in the health department. Specifically, this created less work for the nursing staff and reduced the total amount of time required for a patient visit by a few minutes. These few extra minutes make a huge difference in the overall picture.
Overall, HIV testing rates increased from the baseline data collected in February 2014 of 26% to 77% testing in July 2014, resulting in an increase of 51%.

3. Baseline Data

The Quality Improvement Council looked at HIV testing rates from February 2014 and chose Peach County for the pilot project based on the low number of tests being performed. In regards to baseline data, out of 39 eligible visits, 10 HIV tests were done, equaling a 26% testing rate.

Do
Test the Theory for Improvement

6. Test the Theory

During July 1 – July 31, 2014 the removal of the "confidential HIV test record" form was tested (see right). This is a consent form with demographic information that is unnecessary because this information is already saved in the Mitchell and McCormick database. Removal of this form was approved by program and district leadership prior to implementation.

Act
Standardize the Improvement and Establish Future Plans

9. QI Project Status: ADOPT

Due to the high success rate of this implementation, we have removed the demographic form from the HIV testing process in all 13 counties within the North Central Health District.

10. Communication Plan

QI Coordinator will communicate results to QI Council in September 2014.
An email has been sent to the other 12 counties within the district to notify them of the implementation.
A storyboard has been created from the project charter to be displayed at the NCHD and Peach County Health Department lobby, and as handouts for patients and community partners.