LEARNING SESSION 5Portland Clinic Rapid Fire Presentation

ISSUE: IDC REFERRAL

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lients’ of the Portland Clinic who not on ARV’s are referred to IDC

for consult.

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his is best practice; however wait times to be seen at the IDC can be

long, depending on time of year and availability of specialists

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hen clients’ have appointments they often go AWOL or refuse to go

to appointment. Even with planning it can be difficult to get the

clients’ to their appointments.

INNOVATION: ADDITIONAL PHYSICIAN SUPPORT

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n consultation with the STOP team and the Portland Clinic team it

was agreed that an HIV specialized GP would be added to the clinical

rotation at the rate of 1hour per week/4hours per month.

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his addition allowed for the clients’ to be seen in their own

environment effectively lowering any barriers to accessing care

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lso the addition of an HIV specialized GP provides clinical staff access

to support for any HIV care related questions/concerns

OUTCOMES AND PLANS

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he addition of the HIV specialized GP to the Portland team has

allowed for 4, difficult to engage clients’, to be seen and started

on ARV’s.

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he new HIV specialized GP will see HIV+ clients, provide help

with side effect management, adherence concerns, review

clients’ current regimes and change or update meds if needed.

ISSUE: CURRENT REGISTRY

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he Portland clinic team has done an excellent job keeping clients’ up

to date with their blood-work and engaging clients’ in care.

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ists are updated manually and require a great deal of detective work

to find the details regarding everything from clients’ current meds

to their vaccination records.

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urrent collaborative data set provides limited clinical information

INNOVATION: COLLABORATION

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egional Practice Support Leader Swati Thakkar kindly offered her

assistance and expertise with building a new registry for a complete

clinical snapshot of the Portland Clinic HIV+ clients

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he new registry is designed so that alerts will show up in the different tabs

allowing the user to easily identify client needs and gaps in care. Swati

has created a registry that uses the excel software to populate the cells

according to a pre-set criteria thus reducing data entry time and error.

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hank you Swati for all of your help!!!

OUTCOMES AND PLANS

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he registry is a work in progress, further data is being compiled to complete

the registry for use.

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he registry will become a part of the Portland Clinics’ data base and allow the

user a snapshot of the clinical data regarding the current HIV+ clients’

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t will be a tool for monitoring clients’ status and needs, and an easy

application for which to add new clients’ and move client’s who are MOOGE

to another tab where they can be retrieved easily if they return to the clinic

for care.

TEAM BUILDING: WHO WE ARE & WHERE WE ARE AT

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.5 STOP HIV RN, Stephanie C., in place

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.25 STOP HIV Outreach worker, Meenakshi, in place

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.5 STOP HIV MOA, Ashley, in place

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hrs per month HIV specialized GP, Hand over from current provider Dr. Tu to new

provider Dr. Deans in progress.

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urrent Portland Clinical staff: Physicians Dr. Jafari and Dr. Joe, Clinic RN (Kirsten),

and Clinic Manager: Ashley, supporting the STOP initiative every step of the way.

THINGS TO WORK ON

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ontinue to collect data and update registry

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ork with Portland team, the STOP team and the current outreach HIV

specialized GP to provide care to HIV+ clients and to develop a model that

would allow for easy assimilation of outreach Physicians at the Portland clinic

or at other sites.

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ontinued client engagement and adherence initiatives.

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valuate clients’ current medication regimes and alter if client would benefit

from newer regime.

ANY ADVICE?

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f you have any advice on anything that has worked

for you and your team on any of the above issues and

especially on the topics of continued engagement

strategies and adherence motivation please come

and chat with me at the break