Project Achievements: Hektoen Institute/Cook County Hospital

HRSA HIV/AIDS Bureau's Special Projects of National Significance [1994 - 1999]:

Hektoen Institute/Cook County Hospital

Completed by: Mary Driscoll, R.N., M.P.H.
Last Updated: May 1999

Achievement 1: Able to capitalize on existing systems thereby getting buy- in for the project.

Key Elements for
Success:

Historical – knew perinatal and HIV systems in Cook County.

Factors that Limited
Success:

People bring own agendas – turf issues.

Factors that Ensured
Success:

Formed advisory council with people who were already involved in MCH HIV.

*Achievement 2:* Formation of MCH/HIV Advisory Council to work on key issues around MCH/HIV integration. Council developed: (1) policy on mandatory testing of pregnant women; (2) patient-provider agreement; (3) implementation committees; (4) rapid testing committee to look at (a) ethical issues, (b) practical issues, (c) women’s feelings, and to (d) develop recommendations.
Key Elements for Success: People on Council felt they were part of the project.	Factors that Limited Success: None listed.	Factors that Ensured Success: None listed.

*Achievement 3:* Training, model developing committees to create guidelines for counseling and testing, creating tracking and monitoring for women identified as HIV-positive.
Key Elements for Success: Started out with idea to create system.	Factors that Limited Success: Some staff turnover, not enough early local data collection.	Factors that Ensured Success: Clear plan - foreknowledge of players, dedicated staff, important issue.

*Achievement 4:* Training Manual for Providers.
Key Elements for Success: Collaborated with Illinois Department of Public Health (IDPH) and Illinois Department of Health Services (IDHS).	Factors that Limited Success: Information on perinatal transmission changed rapidly - not enough resources to keep updating.	Factors that Ensured Success: IDPH disseminated - providers call in for Technical Assistance.

*Achievement 5:* Early collaboration with IDPH and IDHS (HIV and MCH). Necessary for our Public Health Model.
Key Elements for Success: Historical relationship with division heads.	Factors that Limited Success: Conflicting agendas at times.	Factors that Ensured Success: Consistent regular meetings sharing information, collaboration on manual and post partum surveys. IDPH/IDHS will collaborate on funding for a staff person to monitor counseling and testing of pregnant women.

*Achievement 6:* Developing and implementing a model of consumer involvement in all aspects of project.
Key Elements for Success: Historical - pool of consumer from HIV PCC.	Factors that Limited Success: Peer leadership difficult to sustain.	Factors that Ensured Success: Systematic, focused work to train peers; stipends for peers, meaningful work for peers.

*Achievement 7:* Ability to get outcome data for model through post-partum survey.
Key Elements for Success: Buy-in and participation in project from hospitals and providers where survey was conducted.	Factors that Limited Success: Busy staff who do not have time to administer survey.	Factors that Ensured Success: Place own staff over survey. Train nurses in post partum to administer survey. Provide encouragement and give data back to hospitals so they can see success or failure.

*Achievement 8:* Ability to work with HMOs and develop script for HIV education, etc.
Key Elements for Success: Understanding the need for flexibility - provide HIV education for all. There is less time to do it in so to provide script that enables providers to educated pregnant women and offer HIV test.	Factors that Limited Success: Bottom line in healthcare.	Factors that Ensured Success: Standard of care.