Table 3.

Enabling factors: organizational expertise, structure, resources, and processes that affect an HIV testing offer to patients

Factor	Explanation	Quotes
1. Time	Developing a model which will allow for HIV testing and not increase waiting time	• “It's kind of hard because your time is already limited as it is, and to explain all the…like he was saying, you come in with a sprained ankle and then you're spending an extra ten minutes explaining all of the risk factors with HIV (resident)”
		• “And that's going to be an extra thing that we have to go to draw the blood. And if that's the only thing that they're waiting for (nurse)”
2. Staff	EDs are already understaffed and this legislation would require additional staffing to be successful.	• “If you had a dedicated person we could potentially discharge them from the emergency department knowing that this dedicated person in real time had obtained a real phone number and was going to really call them back an hour later or maybe they could call them when they were sitting in the waiting room having a snack (nurse)”
		• “Or if the state wants to hire their own person and do their own HIV rapid tests and then could permit some outside facility and just send a letter or phone call or something (resident)”
3. Space	Offering the test and communicating results in a private space	• “It's very different than being in the primary care clinic, when you have a closed office door… (attending physician)”
4. Type of test	Optimum type of test e.g. point-of-care, blood draw, cheek swab	• “And a lot of them don't want it unless it's the swab. They find out it's a needle, they don't want it (attending)”
		• “Yes, cheek swab is easy but it requires training, multiple personnel. It's also a quality issue in point-of-care testing. You know you want to make sure people are doing it right and not missing anything (attending physician)”
5. Timing of the offer	When patients are offered the test during their visit to the ED	• “The easiest thing that could be done, honestly, is when they walk in the door, hand them a slip of paper, yes or no. By doing that, you can build it into everything (resident)”