This is not Jeopardy!

Rectangle of Retention Public Health slide3 Likely Retention “Bennys” Slide 6 Role Play slide 9 Chicken or egg? Slide 12 Consumer Involvement slide 4 To Care is to coordinate care slide 7 Contact! Slide 10 Rate these Rates Slide 13 Operations slide 5 Systems Slide 8 QI Strategy Slide 11 No business like No Show Business Slide 14

Public Health for 100 Which of the following is TRUE –Retention has now been proven to correlate with improved biological outcomes that improve quality of life for patients and reduce the likelihood of further transmission of HIV to others –Retention in healthcare refers to the retention of a lawyer to go to all of your healthcare visits with you just in case…

Consumer involvement for 100 Which of the following is not a good way to involve consumers in increasing retention? –Convene focus group of established patients to provide feedback on retaining new patients –Survey patients who have missed appointments to identify common reasons and barriers –Routinely share results of patient satisfaction surveys w/ Consumer Advisory groups to elicit feedback –Survey new patients immediately following initial visit for satisfaction w/ services –Develop patient satisfaction surveys targeted to patient groups w/ different levels of experience - patients w/ less than 3 visits, patients w/ more than three clinic visits, etc –Have a hot dog eating contest. Whoever eats the most hot dogs is considered retained in care

Operations for 100 Which of the following is NOT an effective Clinic Operation and Information System Strategy? During the clinic visit… Update patient contact information at EACH clinic visit Cross reference all sources of patient contact information to consolidate and update Schedule labs for the next visit Threaten the patient that if they do not show up for their next appointment, you will not validate their parking –

Likely Retention Benefits for 200 Which of the following is NOT true? –If patients are retained in care, they are more likely to A. receive preventive care, B. use emergency services less C. eliminate the deleterious effects of global warming D. keep overall healthcare utilization and costs lower, placing less demand on human and material resources.

To Care is to Coordinate for 200 Which is not true? –Patient Navigators: Make better use of available resources Develop effective communication with providers Navigate complexities of multidisciplinary treatment Fly patients to clinic appointments in private helicopters provided by the state

Systems for 200 Information Systems Which of the following is an effective Clinic Operation and Information System Strategy? –After a Missed Appointment Follow-up calls no later than 24 hours after missed appointment Drop patient from clinic so their lack of attendance does not effect the overall clinic retention rate

Role Play for 500 Name one way the provider role in the provider-patient relationship can facilitate improved retention

Contact! For 500 Which of the following is NOT TRUE: –Increased frequency of patient contact results in fewer gaps in care during first 12 months of follow-up – Reduced frequency of patient contact results in fewer gaps in care during first 12 months of follow-up

QI Strategy for 500 Which is not indicative of a QI Improvement strategy to improve retention? –Consumer involvement to identify barriers & solutions –Reprimanding providers with bad patient retention rates –Increasing staff & patient awareness –Focused case management (internal & external) –Clinic operation & information systems change

Chicken or egg? Which came first? »Viral load elevation or »The missed appointment

The Right Rate for 1000 Retention rates in HIV clinics range from –70-85% in HIV c –59-60% –30-40%

No Business like No Show Business1000 No-show rates range from –10-15% –5-20% –25% to >40% in published studies

Double Jeopardy (not)!!!

Necessity is the Mother of Intervention 2000 Name one program intervention to interrupt the cyclical process of patients coming into and falling out of care that foster sustained HIV care