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Delivery System Design:
Include Planned Visits in the Individual and Group Setting in the Delivery Model

A "planned visit" refers to a pre-scheduled, coordinated visit in which the agenda is determined by the needs of the patient with HIV/AIDS disease. Planned visits are conducted in both the individual and group settings, depending on the type and purpose of the visit. "Group visit" refers to a pre-scheduled visit that includes 8 to 20 patients. Groups range from those providing medical care in a group setting to those led by laypeople to provide emotional support.

  1. Use the registry to identify patients in need of visits.
  2. Designate lay health workers, community health workers, volunteers, or appointment staff to call and schedule patients for visits.
  3. Train staff in the planned visit approach. A planned medical visit should contain an assessment, review of therapy, review of medical care, self-management goals, problem solving, and follow-up planning, including the plan for the next visit.
  4. Assemble a patient visit team, including a provider, nurse, nursing assistant, lay health worker, intake worker, and person in charge of immunization and referrals.
  5. Block time for providers in advance.

 

Specifically for planned group visits:

  1. Identify a patient group to focus on (e.g., Hispanic population, homeless, newly diagnosed).
  2. Obtain senior leadership support for group visits, especially to resolve potential reimbursement issues relating to group settings.

Tips
  • Make planned visits a part of the health center's or clinic’s stated philosophy of care.
  • Conduct a time study to evaluate ideal visit length.
  • Use a multidisciplinary approach to group visits. Include pharmacy, nursing, and case management staff.
  • Try holding visits at homeless shelters, public housing, or churches or other faith-based organizations.
  • Use a "hall monitor" during group visits to take up gaps between services (the monitor can talk with patients about goal setting, educational needs, etc.), and to direct providers and patients to appropriate rooms/areas.
  • Keep track of the number of participants in group visits and the number of "no-shows" for appointments.



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