Dr. Elizabeth Secord
Wayne State University, United States
Title: Quality improvement project: Testing adolescents for HIV in a pediatric emergency room
Biography
Biography: Dr. Elizabeth Secord
Abstract
The vast majority of youth with HIV are referred to our clinic from medical venues. Review of youth in our adolescent HIV clinic reveals that at least 25% presented to an ER during the twelve months prior to diagnosis. These missed opportunities in adolescent HIV diagnosis prompted us to collect data from our pediatric emergency room at Children's Hospital of Michigan which revealed that 200-300 teens aged 13-18 were seen in the ER each month between Nov and Feb 2015 and 30-35 of those adolescents were seen for STI testing, but only an average of 12 per month were offered HIV testing. Barriers to offering testing were identified as discomfort for the practitioner, lack of time and concern about follow-up. A quality improvement program was instituted that partnered our clinic social workers with the hospital social workers to offer education to physicians, nurses and social workers. An on call system was established that made one of our adolescent HIV clinic staff available to do testing during the day and to assist with follow-up at night, relieving the ER staff of this burden. This program has increased HIV testing in the pediatric ER by 40%, but we are still not near our goal of offering standard testing for adolescents in the ER. For more than half of our established adolescent HIV patients, HIV was their first reported STI. By normalizing the testing we hope to make earlier diagnoses, start therapy and decrease new cases.