The RUSH intervention facilitates linkage to and retention in care through an opt-out HIV testing program for people 16 and older who are in an emergency department or other clinical setting and have an intravenous line inserted and/or have blood drawn.
Priority Population: General Population (Ages 16 and Older)
Setting: Emergency Departments, Ryan White HIV/AIDS Program Clinics
Location: Houston, TX
Intervention Focus: Linkage, Re-engagement, and Retention
Study Period: 2008-2012
Outcomes, Components, Cost Analysis
Outcomes
47.1% of clients were actively retained in care six months after implementation.
Clients’ viral suppression rate increased from 22.8% pre-intervention to 34% post-intervention.
Intervention Components
Address Staffing and Workflow Needs
Secure Organizational Buy-In
Establish a Steering Committee
Determine Funding Streams
Recruit Additional Staff
Develop Promotional Materials
Train ED Staff on RUSH Procedures
Implement and Sustain RUSH
Cost Analysis
The RUSH intervention 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
Lack of buy-in
Identify a champion within your organization who can promote it to leadership. Highlight the benefits of implementing RUSH.
Lack of off-hours service linkage worker (SLW) coverage
Expand after-hours SLW coverage or hire an SLW who is dedicated to following up with clients who are not linked to care after receiving an HIV diagnosis.
Staff turnover and ongoing RUSH training
Develop a strategy for disseminating RUSH training to new staff, including building institutional knowledge by coaching RUSH-focused staff, who can in turn train new staff.
Lack of diverse RWHAP funding
Assess the availability of RWHAP Part A funding during the planning phase so you can strategize ways to offset costs if that funding is not available. Discuss repurposing existing funding; petition leadership for more sustainable funding; partner with agencies that have RWHAP funding or other diverse funding streams.
HIV testing laws
Learn from organizations that have implemented similar interventions to identify approaches that may be effective in your jurisdiction. Also, learn about testing laws in other jurisdictions that promote access to routine opt-out HIV testing.
