title: Retention: building a patient-centered medical home in HIV primary care through PUFF (Patients Unable to Follow-up Found).
abstract: Here, we describe our patient-centered medical home (PCMH) quality improvement retention project conducted by a Health Resources and Services Administration (HRSA) Ryan White-funded Primary Care HIV clinic. The single urban academic clinic serving 2,776 active HIV positive patients identified 25.8% (716/2,776) patients who had not been retained in care within the prior six months during two separate six-month interval analyses. Multiple modalities including a retention specialist, a secure clinic phone message line, algorithms, flyers, brochures, database, and staff education were built to facilitate re-engagement. The project located 87.7% (628/716) patients who had not been retained. The retention specialist was directly responsible for the return of 16.2% (116/716) patients. Results from the project demonstrated that a formalized approach is a necessary component to effective retention efforts. We believe that this work will provide a strategic framework for the development of randomized control trials to formally evaluate an HIV retention intervention.
authors.affiliation: Owen Clinic and Department of Medicine at University of San Diego, California, USA. asitapati@ucsd.edu
authors.forename: Amy M
authors.initials: AM
authors.lastname: Sitapati
authors.forename: Jan
authors.initials: J
authors.lastname: Limneos
authors.forename: Militza
authors.initials: M
authors.lastname: Bonet-Vázquez
authors.forename: Moira
authors.initials: M
authors.lastname: Mar-Tang
authors.forename: Huifang
authors.initials: H
authors.lastname: Qin
authors.forename: W Christopher
authors.initials: WC
authors.lastname: Mathews
mesh_terms: D003266:Continuity of Patient Care; D015658:HIV Infections / Q000628:therapy*; D006801:Humans; D059012:Lost to Follow-Up; D018802:Patient-Centered Care / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D011785:Quality Assurance, Health Care / Q000379:methods*; D012189:Retrospective Studies