Implementation of an Opt-Out Outpatient HIV Screening Program.

Background: Screening rates for Human Immunodeficiency Virus (HIV) remain low despite guidelines by both the CDC and USPSTF recommending that all adolescents and adults be screened at least once. The aim of this quality improvement study was to increase HIV screening among eligible patients.

Methods: This quality improvement study assessed the impact of interventions to increase HIV screening in an outpatient population at a large urban safety-net hospital.

Patient Perceptions of Penicillin Allergy Testing in a Public Health System.

Background: Documented penicillin allergies are associated with increased morbidity, increased hospital stay, and an increase in resistant infections. Penicillin allergy evaluations using a direct oral challenge with or without skin testing has been recommended as a delabeling strategy for patients with penicillin reaction histories. Barriers for achieving equitable access, however, exist.

Using Machine Learning to Identify Patients at Risk of Acquiring HIV in an Urban Health System.

Background: Effective measures exist to prevent the spread of HIV. However, the identification of patients who are candidates for these measures can be a challenge. A machine learning model to predict risk for HIV may enhance patient selection for proactive outreach.

Missed Opportunities for HIV Prevention in a Large County Safety Net Health System.

Introduction: HIV pre-exposure prophylaxis (PrEP) is effective at reducing HIV transmission. However, PrEP uptake is low for racial and ethnic minorities and women, especially in the Southern US Health care clinicians should be prepared to identify all patients eligible for PrEP, provide counseling, and prescribe PrEP.

Methods: Retrospective analysis of persons newly diagnosed with HIV was conducted at a large public health system from January 2015 to June 2021.

Intersecting social determinants of health among patients with childcare needs: a cross-sectional analysis of social vulnerability.

Introduction: Access to childcare is an understudied social determinant of health (SDOH). Our health system established a childcare facility for patients to address childcare barriers to healthcare. Recognizing that social risk factors often co-exist, we sought to understand intersecting social risk factors among patients with childcare needs who utilized and did not utilize the childcare facility and identify residual unmet social needs alongside childcare needs.

Implementation of Sexual Health Curriculum Series: Educational Initiative to Increase STI Screening and Treatment in Dallas, Texas.

Objective: A new monthly virtual education curriculum on sexual healthcare was launched in 2021. This is an analysis of the pilot education series designed to increase primary care providers' knowledge of sexual health best practices including taking thorough sexual histories, STI screening and treatment, and PrEP prescribing.

Methods: A Sexual Health Curriculum Series was developed as part of a quality improvement initiative at a large urban safety-net hospital in Dallas County, Texas.

Addressing childcare as a barrier to healthcare access through community partnerships in a large public health system.

Objective: In our public health system, a survey of reproductive-aged women identified lack of childcare as the most common reason for missing or delaying healthcare. Community-based organisations (CBOs) in our county identified a similar need, so we partnered to develop a hospital-based childcare centre for patients to use during appointments.

Methods: In a large academic public health system, a partnership with a non-profit childcare CBO was formed to address lack of childcare as a barrier to accessing healthcare.

Impact of a clinical pharmacist within an HIV PrEP program for patients experiencing homelessness.

Background: Human immunodeficiency virus (HIV) continues to be a concern in the United States despite pre-exposure prophylaxis (PrEP) being a highly recommended preventative option. Homeless populations have a significantly increased risk of HIV acquisition, and recent literature found attrition to PrEP care being concentrated in demographics common to these populations. Pharmacist-led PrEP programs may be a feasible option to combat this attrition, as they have shown high rates of patient satisfaction and pharmacist comfortability in other populations.

Effect of the COVID-19 Pandemic on Chlamydial Infection Treatment in Women Discharged From an Urban Safety-Net Emergency Unit.

Background: Chlamydia is the most frequently reported sexually transmitted infection. COVID-19 exacerbated the challenges in treating and preventing new Chlamydia trachomatis (CT) infections. This study examined the impact of COVID-19 on treating CT-positive patients discharged from a safety-net women's emergency unit.

Real-Time Risk Tool for Pharmacy Interventions.

Background: Adverse drug events (ADEs) result in excess hospitalizations. Thorough admission medication histories (AMHs) may prevent ADEs; however, the resources required oftentimes outweigh what is available in large hospital settings. Previous risk prediction models embedded into the Electronic Medical Record (EMR) have been used at hospitals to aid in targeting delivery of scarce resources.

Co-Created Messaging for Influenza Vaccination in a High-Risk Hispanic Community Provides Groundwork for COVID-19 Vaccine.

Influenza/pneumonia is the eighth leading cause of death in the United States. The 2020-2021 influenza season is predicted to be further impacted by COVID-19 infections. Historical data reflect disproportionate morbidity and mortality rates in the Hispanic population for influenza and COVID-19.

Penicillin Allergy Delabeling: A Multidisciplinary Opportunity.

The penicillin allergy label has been consistently linked with deleterious effects that span the health care spectrum, including suboptimal clinical outcomes, the emergence of bacterial resistance, and increased health care expenditures. These risks have recently motivated professional organizations and public health institutes to advocate for the implementation of penicillin allergy delabeling initiatives; however, the burden of delabeling millions of patients is too expansive for any one discipline to bear alone. This review presents the unique perspectives and roles of various stakeholder groups involved in penicillin allergy diagnosis, assessment, and delabeling; we emphasize opportunities, barriers, and promising areas of innovation.

Pharmacist impact on health outcomes in a homeless population.

Objective: The aim of this study was to analyze the effect of clinical pharmacy services on health outcomes and medication adherence concerning hypertension and diabetes in the homeless population.

Methods: This was a retrospective quasi-experimental study conducted between January 1, 2015, and December 31, 2016. The primary outcomes included median blood pressure and median glycosylated hemoglobin (A1C) change from baseline.

Aiming Beyond: A Pharmacist Impact on 90-Day Readmissions and Clinical Outcomes Within a Family Medicine Service.

Previous studies have shown pharmacists positively impact 30-day readmission rates. However, there is limited data regarding the effect of clinical pharmacist (CP) follow-up on 90-day readmission or evaluation of disease-specific goals after hospitalization. Investigators analyzed the impact of postdischarge extended CP follow-up within a family medicine service (FMS).

Standardizing the Use of Albumin in Large Volume Paracentesis.

Background: Albumin after large volume paracentesis (LVP) reduces paracentesis-induced circulatory dysfunction (PICD). The most efficacious dose of albumin for LVP is unclear.

Objective: To evaluate the impact of implementing a standardized LVP order set on albumin utilization and patient outcomes.

Improving Aztreonam Stewardship and Cost Through a Penicillin Allergy Testing Clinical Guideline.

Background: Patients reporting penicillin allergy often receive unnecessary and costly broad-spectrum alternatives such as aztreonam with negative consequences. Penicillin allergy testing improves antimicrobial therapy but is not broadly used in hospitals due to insufficient testing resources and short-term expenses. We describe a clinical decision support (CDS) tool promoting pharmacist-administered penicillin allergy testing in patients receiving aztreonam and its benefits toward antimicrobial stewardship and costs.

A Proactive Approach to Penicillin Allergy Testing in Hospitalized Patients.

Background: Penicillin allergy testing is underutilized in inpatients despite its potential to immediately impact antibiotic treatment. Although most tested patients are able to tolerate penicillin, limited availability and awareness of this tool leads to the use of costly and harmful substitutes.

Objective: We established an inpatient service at a large academic hospital to identify and test patients with a history of penicillin allergy with the goals of removing inaccurate diagnoses, reducing the use of beta-lactam alternatives, and educating patients and clinicians about the procedure.

Low-health literacy flashcards & mobile video reinforcement to improve medication adherence in patients on oral diabetes, heart failure, and hypertension medications.

Objective: To design and investigate a pharmacist-run intervention using low health literacy flashcards and a smartphone-activated quick response (QR) barcoded educational flashcard video to increase medication adherence and disease state understanding.

Design: Prospective, matched, quasi-experimental design.

Setting: County health system in Dallas, Texas.

Impact of a Pharmacy-Led Pain Management Team on Adults in an Academic Medical Center.

Pain is a major health problem affecting more than 15% of adults in the United States. In a multidisciplinary pain management team, pharmacists can optimize pharmacotherapy quality by ensuring safe and appropriate medication use. Assess the impact of a pharmacy pain medication management service on pain-related outcomes in an adult inpatient population.