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Improving Retention Workshop Breakout Notes 2/18/2010

Improving Retention Workshop Breakout Notes 2/18/2010. Barriers Brainstorm. Lack of communication with providers Charts go off site before known with providers Lack of understanding of importance Level of complacency Change of pt. population/lack of staff understanding of pt. barriers

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Improving Retention Workshop Breakout Notes 2/18/2010

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  1. Improving Retention Workshop Breakout Notes2/18/2010

  2. Barriers Brainstorm • Lack of communication with providers • Charts go off site before known with providers • Lack of understanding of importance • Level of complacency • Change of pt. population/lack of staff understanding of pt. barriers • Homelessness • Substance abuse • Special populations (e.g. prison release) • Retention rate vs. no show rate • Co-morbidities/other chronic care issues • Psychological burnout for pts. • Travel/transportation/public transportation • Current contact info, esp for unstable housing, relocated or those who may have not disclosed status to others and don’t provide accurate info

  3. Barriers Brainstorm • Need for same-day care after testing positive • Pt. who work have difficulties getting time off for appts • Need for weekend and evening hours • “AIDS” in name of clinic • Denial of disease status • Staff retention/turn-over • Support systems (parents, generational belief systems • Cultural beliefs around healthcare • Wait of appoints/length of time between • Health literacy • Lack of comfort with provider (e.g. male gyn, etc) • Staff who don’t speak same languageChildcare needs

  4. Solutions 1.Addressing pts with mental health issues • Offer HIV testing at inpatient and out patient psyche facilities • Increase $ for onsite mental health services • Increase access to mental health, acceptance of ADAP/Medicare

  5. Solutions 2. Lack of pt. understanding of importance of visit/denial • Improving orientation for new patients (monthly welcome breakfast, offer peer services from beginning, best way to communicate with pt from beginning) • Using existing support groups/consumers to get input/feedback on ideas • Teach staff to use health literacy techniques and tools • Obtain baseline assessment of pt. healthcare values • Improve staff communication skills • Staff and pt. collaboration to develop care plan • Address pt’s other priority needs first (food, housing, etc)- one-stop shop for services • Address coordination and communication of staff so all are aware of pt. needs

  6. Solutions 3. Wait time • Acknowledge that patients’ time is important- keep them updated on wait times • How to effectively manage walk-ins to not impact scheduled appts. (e.g. algorithm for walk-ins) • Schedule other activities while waiting to see clinician to use time effectively (see CM, nutritionists, etc)

  7. Solutions 4. Current Contacts • Refer to free phone and minutes from state • If moved, refer to local services • Ensure contact info is up-to-date at each visit • Be proactive- ensure patients are enrolled in SNPS • Ability to contact other stakeholders/providers regarding pt follow up/current care • Ability to contact insurance carriers and other outside agencies (i.e. COBRA) to follow up on pts.

  8. Solutions 5. Health Literacy • Use patient-centered approach to identify how pt best learns- offer an range of methods for pts to choose from • Develop presentations/formats that appropriate to pt. needs • Continued training for staff around health literacy

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