How to Incorporate Testing In Patient Flow

Routine HIV testing programs are generally conducted by either internal clinical staff or dedicated testers to perform the test, give results and link patients to care. These models known as integrated or parallel systems, respectively, have proven successful in a variety of medical settings. While dedicated tester models are very effective in rapidly scaling up the number of tests conducted, integrated models are more likely to make testing routine and sustainable over time.

Depending on your setting, information provision and HIV testing will be integrated into patient flow at a different place. The following tools are provided to help you decide what will work best for your circumstances.

How to Incorporate Testing In Patient FlowDownloadable Resources
(Please right-click to download each resource.)
  1. Health Center Model – See Step 3 (NACHC, 2009)
    This document provides a model for how a community health center (CHC) can design a process where everyone 13 to 64 years of age is screened for HIV as a routine part of medical care. The tools and resources referenced were developed, tested, and successfully used by six community health centers participating in a Routine HIV Screening pilot supported by the Centers for Disease Control and Prevention (CDC).
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  2. Capacity Assessment – See Worksheet #2 (PAETC, 2008)
    “Worksheet 2: Assessing Policies and Procedures” addresses issues to consider in implementing routine HIV testing including patient flow. 
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  3. Sample Flow Sheet (Urban Health Plan, Inc.)
    This flow chart is an example of how testing might occur in a clinical setting with an electronic medical record system.
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  4. FOCUS Flow Chart (Jackson Park Hospital) 
    An example of routine HIV testing is shared here by Jackson Park Hospital.
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  5. Emergency Department HIV Screening Flow Chart (St. Christopher’s Hospital, 2011)
    An example of an Emergency Department Flow Chart practiced at St. Christopher’s Hospital.
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  6. Rapid Testing in the Emergency Department (HHC)
    This flow chart is an example of a dedicated testing program in an Emergency Department. Even if you are not in an ED, the chart may provide some ideas about developing a dedicated testing program.
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  7. Routine Testing in the ER (Dr Jeremy Brown, GWU)
    This chart is an example of the flow for testing in an Emergency Room setting.
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  8. Applying HIV Testing Guidelines in Clinical Practice (AFP, 2009)
    This article discusses the barriers faced while testing and how the current HIV testing guidelines address many of these barriers by making the testing process more streamlined and less stigmatizing.
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  9. Community Health Centers (CDC, 2011)
    More and more community health centers (CHCs) are providing HIV testing. CHCs are important places to offer HIV testing because the patients who receive medical care there are often members of groups that may be at high risk of HIV infection.
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  10. HIV Testing in Health-Care Settings (AETC , NRC, 2006)
    These slides were developed using the September 2006 HIV Testing Guidelines. The intended audience is clinicians involved in the care of patients with HIV, but it also contains information helpful for any person involved with HIV testing.
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