CrescentCare partnered with the New Orleans Office of Health Policy to implement the CrescentCare Start Initiative (CCSI), which aimed to start all people with HIV who have been newly diagnosed on antiretroviral therapy (ART) within 72 hours of diagnosis to increase treatment uptake and viral suppression outcomes. The intervention provided a 24-hour navigator to coordinate linkage services, and it streamlined the intake process for a focused HIV visit with a treatment provider.
About the Project
An initiative designed to link people newly diagnosed with HIV to care and treatment within 72 hours
Priority Population: General Population
Setting: Partnerships (combination of settings)
Location: New Orleans, LA
Intervention Focus: Linkage
Study Period: 2016 – 2017
Outcomes, Components, Cost Analysis
Outcomes
- 92% of patients were linked, saw a treating provider, and started ART within 72 hours of diagnosis.
- The mean time to linkage in the historical cohort was 30 days compared to 1.3 days in CCSI.
Intervention Components
- Linkage to medical care by the Patient Navigator
- Provider visit to perform intake
- Administration and prescribing of ART medication
- Lab visit
- Linkage to benefits and social services
- Patient navigator check-in
Cost Analysis
The CCSI cost analysis is not currently available. However, you can use the CIE Cost Calculator to create an estimate of the cost of implementing the intervention at your organization.
Challenges and Solutions
| Challenge | Solution |
|---|---|
| Service-Delivery Changes | Discuss the reasoning behind prescribing ART before intake and laboratory results with clinicians. Gather input as they adopt the new practice. |
| Limited Resources | Secure funding to support patient navigation, immediate patient access, and medication coverage for the first 30 days of medication. |
| Disruptions in ART Coverage | Offer flexible hours and insurance navigation services for clients. |
| Organizational Limitations | Ensure provider and leadership are invested in the care model. |
| COVID-19 | Maximize access to care and minimize unnecessary in-person visits by leveraging alternative tools such as telehealth. |
Implementation Resources
Publications
- Linkage and Antiretroviral Therapy Within 72 Hours at a Federally Qualified Health Center in New Orleans
- Rapid Antiretroviral Therapy: Time for a New Standard of Care
- A Care Continuum of Immediate ART for Newly Diagnosed Patients and Patients Presenting Later to Care at a Federally Qualified Health Center in New Orleans
Supplementary Resources
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