Implementation of a Rapid HIV Testing Program in an Emergency Department

Boston, Massachusetts (PressExposure) October 23, 2009 -- In 2006, the Centers for Disease Control and Prevention (CDC) recommended that HIV testing be offered to adults aged 13-64 in all healthcare settings, including the emergency department (ED). Since then, EDs throughout the United States have begun to implement rapid testing programs as a public health screening service. In the absence of guidelines on how to implement these recommendations into clinical practice, researchers from Brigham and Women's Hospital (BWH) have outlined a framework of lessons learned during the establishment of a rapid HIV testing program in an academic teaching hospital. These findings are published online in the International Journal of Emergency Medicine.

"Although at times challenging, we believe that routine HIV screening in the ED is feasible with appropriate infrastructure and with longitudinal and financial support. We offer this framework so that others both domestically and internationally who are poised to embark on HIV testing programs may benefit from our experiences," said Christian Arbelaez, MD, MPH, of the BWH Department of Emergency Medicine, Assistant Professor of Medicine at Harvard Medical School and lead author of the paper.

Researchers implemented this program over the course of a year which included time for advanced planning, piloting, and continuous refinement of programmatic details. Highlights of the framework identified in creating a successful HIV testing program in the emergency department included: identifying a champion, performing a needs assessment, engaging a comprehensive team, selecting an appropriate HIV test, establishing proper protocols and quality assurance measures, and providing education and training for the providers.

"While we have found that it is entirely possible to develop an HIV screening program in an emergency department, we have also experienced the challenges that arise along the road to implementation. Developing an interdisciplinary team of supportive clinical and administrative staff is a critical step in the success of this public health service," said Rochelle P. Walensky, MD, MPH, of the BWH and Massachusetts General Hospital (MGH) Divisions of Infectious Disease, Associate Professor of Medicine at Harvard Medical School, senior author of the study.

"We hope that components of this program will serve as a model and preliminary guidance for EDs throughout the United States. In international settings, many of the recommendations may also be applied, with careful attention to country- and setting-specific details." said Arbelaez.

Additional co-authors of the International Journal of Emergency Medicine report are Brian Block, Elena Losina, Elizabeth A. Wright, William M. Reichmann, Regina Mikulinsky, Jessica D. Solomon, and Matthew M. Dooley. Experiences leading to this review and efforts to write it were funded by the National Institute of Mental Health and the Doris Duke Charitable Foundation Clinical Scientist Development Award. ClinicalTrials.Gov: #NCT00502944

About Brigham and Women's Hospital

Brigham and Women's Hospital (BWH) is a 777-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare, an integrated health care delivery network. In July of 2008, the hospital opened the Carl J. and Ruth Shapiro Cardiovascular Center, the most advanced center of its kind. BWH is committed to excellence in patient care with expertise in virtually every specialty of medicine and surgery. The BWH medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in quality improvement and patient safety initiatives and its dedication to educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Biomedical Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, involving more than 860 physician-investigators and renowned biomedical scientists and faculty supported by more than $416 M in funding. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative. For more information about BWH, please visit Brigham and Women's Hospital.


Brigham and Women's Hospital
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Boston, MA 02115 USA
http://www.brighamandwomens.org/

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Press Release Submitted On: October 22, 2009 at 4:47 am
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