Development of a Quality Measure to Improve HIV and Syphilis Screening in the Emergency Department: A Modified Delphi...

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Healthcare Quality Improvement

Background:

• Emergency department (ED) screening is vital for addressing the human immunodeficiency virus (HIV) epidemic.
• Current ED screening rates for HIV remain suboptimal, necessitating improved strategies.

Purpose of the Study:

• To develop a quality measure aimed at enhancing HIV screening rates among patients in emergency departments.
• To identify the most impactful and feasible approach for quality measurement in ED-based HIV screening.

Main Methods:

• A modified Delphi process involving 10 emergency physicians with expertise in preventive health and quality measurement.
• Review of peer-reviewed literature and national guidelines to identify high-risk populations.
• Anonymous surveys and consensus discussions to rank screening approaches based on impact and feasibility.

Main Results:

• The panel identified ED patients undergoing testing for other sexually transmitted infections (STIs) as the highest impact and most feasible group for quality measurement.
• A quality measure focused on "co-screening" for HIV alongside STI testing was successfully designed.

Conclusions:

• The developed quality measure for HIV co-screening in EDs can improve detection and linkage to care.
• This approach aligns with emerging healthcare strategies balancing health impact with implementation feasibility.
• Implementing this measure can contribute to controlling HIV and other STI epidemics.