Programming Connection

Immunodeficiency Clinic (IDC) 

St. Paul's Hospital
Vancouver, British Columbia
2013

Evaluation

The IDC has a culture of continuous quality improvement, and the clinic’s services and programs are frequently evaluated to improve the patient experience.

Evaluation at the clinic can be divided into two broad categories:

  1. continuous quality improvement
  2. STOP Project evaluation

Continuous quality improvement

The IDC’s Quality Improvement Group meets monthly to analyze quality improvement data captured by the clinic. The group uses the data to improve or introduce new services, tailored to patient needs. The Quality Improvement Group also assists specific teams or programs within the clinic to establish appropriate indicators to evaluate their own services.

Patient satisfaction is assessed through a patient advisory group. To make the group as accessible and low barrier as possible, patients are invited to provide feedback on the clinic’s services and programs and to share their experiences bimonthly. Food is offered to anyone who stops in.

STOP Project evaluation

With the introduction of the STOP Project, the IDC analyzed data it collected to measure its success according to several indicators, including the number of clients on antiretroviral therapy who were clinically indicated for treatment, the number of people who had recent CD4 and viral load counts and the number of patients engaged in care.

The analysis revealed that a number of the clinic’s clients had been lost to care and that the clinic needed a process to re-engage clients in care. As a result of this analysis, the IDC now takes a proactive approach to re-engaging clients and makes telephone calls, sends letters and involves the case management team when necessary.

Peer navigators

The Peer Navigators Program has been evaluated both quantitatively and qualitatively to determine its effectiveness at supporting people to engage in care. By tracking the frequency of sessions between navigators and clients and by having clients rate their experience with navigators and their own knowledge level regarding HIV, the IDC determined that most people’s self-confidence and their knowledge of HIV and how to manage it increased as a result of their interactions with peers.

The IDC also evaluated the partnership among the STOP Outreach Team, the IDC, the HIV acute care unit at St. Paul’s and the peer navigators. This evaluation determined that clinical staff appreciated having peers on their teams because they provided support and education on the basis of their experiences of living with HIV.

Point-of-care testing

The IDC collects quantitative data on the point-of care testing initiative, including the number of tests performed and the number of positive results. Staff also collect data on where people heard about the service and why they chose the IDC for their rapid test. Results to date indicate that 50 percent of people getting tested found out about the service online and that many patients prefer the hospital setting for testing because it offers more anonymity than a sexual health clinic or their family doctor’s office.

Mental health team

As of November 2012, the mental health team is only tracking quantitative data on the number of people referred and the number of people being transitioned to other mental health services. These data are being collected to determine if the team needs more capacity and whether it should be partnering with other services and organizations to offer mental health support to patients.

Intensive case management

As of November 2012, the IDC is refining its case management service and creating new evaluation criteria to better measure patient outcomes.