Clinic-Based Surveillance-Informed

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.

Summary

Resumen

About the Project

Image credit

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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

Outcomes, Components, Cost Analysis

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

Refer to the CBSI Cost Analysis Summary. You can also use the CIE Cost Analysis Calculator to create an estimate for implementing the intervention at your organization.

Challenges and Solutions

Challenge	Solution
Barriers to Care	Consider offering incentives and connecting with local service agencies to address barriers to care.
Lack of Referrals	Educate doctors about the intervention to facilitate referrals.
Lack of Administrative Support	Seek ways to sustain linkage activities to ensure active remains an organizational priority.
Data Management	Use a database that allows staff to gather, extract, and analyze client-level data.
Data-Sharing Complications	Improve the data-sharing process by gathering information about current clinic policies and lessons learned from other interventions.
Delayed Data Sharing	By improving the timeliness of data sharing, organizations can ensure that they have the most up-to-date client information, which can facilitate prompt re-linkage effort.
Undefined Staff Roles:	Clearly convey roles and responsibilities and how these may sometimes overlap.
Staff Burnout	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.
Losing Sight of Long-Term Goals	Focus on sustained engagement in care as the goal rather than re-linkage. The linkage specialist can work with providers to identify barriers to sustained engagement in care so that they can address the barriers with clients.