Effect of Clinical Program Integration on Eliminating Disparities in Access to Care

Background:
This session will describe the efforts made by the Fulton County Department of Health and Wellness to strengthen the public health infrastructure through integration and collaboration of clinical services. Maximizing the capability of each position through cross training in the STD, HIV and Tuberculosis clinics has improved services. Prior to 2004, the three services were under separate administration. The need for different services resulted in delayed access because of patient movement to different clinics. Integration of programs, cross training of staff and offering multiple services in each clinic has shortened the waiting time for clients.

Objective:
(1) Develop systems to improve infrastructure, work force training, and team work to increase efficiency in the public health system. (2) List and monitor the job duties of each public health staff position to increase the individual capabilities.

Method:
This session will describe the efforts made to strengthen the public health infrastructure by integration and collaboration of clinical services by the health department. Staff was cross trained in procedures, disease process and data collection. Clients are offered multiple STD/HIV/TB services in the clinic they attend as a “one-stop” shop.

Result:
Success was demonstrated by stabilizing the syphilis and HIV new infections. Also, tuberculosis case rate declined from 14 in 2004 to 7.6 in 2006. Cross training has resulted in more efficient and cost effective patient care, referrals for patients and partners, better communication with collaborators and stake holders. Client compliance has improved with decrease in waiting time.

Conclusion:
Integration of clinical services should be promoted to improve access for disadvantaged clients.

Implications:
Ongoing communication, cross training, and clinical program integrations are necessary to enhance access, contain costs, and provide quality care in the public health system.