Increasing Admissions of HIV Positive Patients

Denver Medical Health Center is Colorado's primary "safety net" institution. Outpatient Behavioral Health Services provides substance abuse treatment services to more than 800 people each year.

This change project aimed to increase admissions of HIV positive patients referred to OBHS from Denver Public Health's Infectious Disease Clinic (ID) and Primary Care Clinic (PCC).

Changes tested to increase admissions of HIV positive patents included:

• Offering a weekly LGBT-specific group of HIV positive patients. The group was open to all hospital patients identifying as LGBT and provided a culturally competent therapeutic environment. The change team distributed flyers, posters, and tickets at the ID Clinic and PCC. After attending the group several times, a number of patients enrolled in services.
• Requesting a daily e-mail list of all HIV-positive patients that are inpatient at the hospital, allowing the change team to provide outreach.
• Changing the referral process to meet patient needs. We found that it worked better for the patient to have a scheduled intake appointment rather than the option of a walk-in intake.
• Monthly meetings between ID Clinic, PCC, and OBHS staff. Social workers from the ID Clinic provided education to the substance abuse team on services available for HIV-positive patients.

The initial goal was to increase admissions from 1 per month to 2 per month. The change team surpassed that goal by the third month, with 1 to 2 intakes per week. With the increase in revenue we hired a counselor to work with the added patients.

• Helping patients who are HIV-positive and who need substance abuse treatment comply with their primary medical care for HIV increases their health overall.
• Networking with other agencies to provide continuity of care is hard work to start but is sustainable once a solid referral process is in place.

The new counselor will work with ID Clinic/PCC to improve relations and the likelihood of continued referrals.