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Increasing and sustaining blood-borne virus screening in Spain and Portugal throughout the COVID-19 pandemic: a multi-center quality improvement intervention

2024Journal article Open access
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dc.contributor.authorVaz-Pinto, I
dc.contributor.authorOrtega, E
dc.contributor.authorChivite, I
dc.contributor.authorButí, M
dc.contributor.authorTurnes-Vázquez, J
dc.contributor.authorMagno-Pereira, V
dc.contributor.authorRocha, M
dc.contributor.authorGarrido, J
dc.contributor.authorEsteves-Santos, C
dc.contributor.authorGuimaraes, M
dc.contributor.authorMourão, T
dc.contributor.authorMartínez Roma, M
dc.contributor.authorGuilera, V
dc.contributor.authorLlaneras-Artigues, J
dc.contributor.authorBarreira-Díaz, A
dc.contributor.authorPérez Cachafeiro, S
dc.contributor.authorDaponte Angueira, S
dc.contributor.authorXavier, E
dc.contributor.authorVicente, M
dc.contributor.authorGarrido, G
dc.contributor.authorHeredia, MT
dc.contributor.authorMedina, D
dc.contributor.authorGarcía Deltoro, M
dc.date.accessioned2024-02-14T21:37:32Z
dc.date.available2024-02-14T21:37:32Z
dc.date.issued2024
dc.description.abstractBackground: Around 57,000 people in Spain and Portugal currently living with HIV or chronic hepatitis C are unaware of their infection. The COVID-19 pandemic severely disrupted screening efforts for these infections. We designed an intervention to increase and sustain opportunistic blood-borne virus (BBV) screening and linkage to care (SLTC) by implementing the TEST model. Methods: The Plan Do Study Act (PDSA) method of quality improvement (QI) was implemented in 8 healthcare organizations (HCOs), including four hospitals, two clusters of community health centers, and two community-based organizations (CBOs). Baseline assessment included a review of BBV SLTC practices, testing volume, and results 12 months before the intervention. Changes in BBV testing rates over time were measured before, during, and after the COVID-19 lockdowns in 2020. A mixed ANOVA model was used to analyze the possible effect on testing volumes among HCOs over the three study periods. Intervention: BBV testing was integrated into normal clinical flow in all HCOs using existing clinical infrastructure and staff. Electronic health record (EHR) systems were modified whenever possible to streamline screening processes, implement systemic institutional policy changes, and promote QI. Results: Two years after the launch of the intervention in screening practices, testing volumes increased by 116%, with formal healthcare settings recording larger increases than CBOs. The start of the COVID-19 lockdowns was accompanied by a global 60% decrease in testing in all HCOs. Screening emergency department patients or using EHR systems to automate screening showed the highest resilience and lowest reduction in testing. HCOs recovered 77% of their testing volume once the lockdowns were lifted, with CBOs making the fullest recovery. Globally, enhanced screening techniques enabled HCOs to diagnose a total of 1,860 individuals over the research period. Conclusions: Implementation of the TEST model enabled HCOs to increase and sustain BBV screening, even during COVID-19 lockdowns. Although improvement in screening was noted in all HCOs, additional work is needed to develop strong patient linkage to care models in challenging times, such as global pandemics.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationFront Public Health . 2024 Jan 24:11:1268888.pt_PT
dc.identifier.doi10.3389/fpubh.2023.1268888pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.26/49837
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectCOVID-19pt_PT
dc.subjectInfecções por VIHpt_PT
dc.subjectHepatite Cpt_PT
dc.subjectHepaciviruspt_PT
dc.subjectHIV Infectionspt_PT
dc.titleIncreasing and sustaining blood-borne virus screening in Spain and Portugal throughout the COVID-19 pandemic: a multi-center quality improvement interventionpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleFrontiers in Public Healthpt_PT
oaire.citation.volume11pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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