Identify and prepare champions |
Key staff shareholders |
Prior to and during implementation of the bundle |
Champions passionate about improving healthcare for people who inject drugs is one of the most successful strategies in the literature. |
Capture and share local knowledge |
Clinicians who care for PWID and hospitalized PWID |
Prior to and during implementation of the bundle |
Patients and clinicians have an incredible amount of knowledge about the multi-level barriers preventing HIV testing. We captured local knowledge through in-depth interviews, survey, and field notes to inform the development of the PWID bundle. |
Conduct educational meetings |
Clinicians |
Prior to and during implementation of the bundle |
We identified several knowledge gaps in understanding evidence-based care for PWID as well as the rules around HIV testing. Educational meetings allowed for a forum for clinicians to ask questions. Educational meetings were necessary to teach about the PWID bundle. Although details were emailed to all clinicians, the internal medicine residents were often too busy to read or meaningfully interact with information delivered through email. |
Distribute educational materials |
Medicine residents |
Prior to and during implementation of the bundle |
A common theme found in the pre-implementation medicine resident survey was forgetting to ask about HIV testing. We developed flyers to remind people about the PWID bundle and posted them in places where internal medicine residents work. |
Make training dynamic |
Medicine residents |
Prior to and during implementation of the bundle |
We noticed that in preliminary discussions with internal medicine residents, they seemed tired and disengaged. We created different systems of education, including “role-play” exercises and case-based presentations to encourage the internal medicine resident participation. |
Use mass media |
Medicine residents |
During the implementation of the bundle |
Champions and project team members developed a 3-min jingle to the tune of “ABC” by Michael Jackson to reinforce the components. To make this easily accessible, the residents recorded themselves singing the jingle and published it on YouTube, an accessible and popular website among the medicine residents. |
Conduct ongoing training |
Medicine residents |
During and after implementation of the bundle |
We included the details of the PWID bundle in the resident handbook that is distributed to new residents each July. |