P444 Changing Practices in a large urban HIV clinic in response to Covid-19

Keane, A.; Lyons, F.; Loy, A.

Background/PurposeIn March 2020 the World Health Organisation declared Covid-19 a global pandemic. Ireland responded by shutting all non-essential shops, businesses and schools. Our healthcare system had to adapt and rapid adaptations were made to ambulatory HIV care.ApproachRecords were virtually reviewed and triaged using existing electronic patient records(EPR) prior to appointments. Antiretrovirals(ARVs) were pre-prescribed and prepared by pharmacy for those anticipated to remain on the same ARVs. We determined those for whom routine phlebotomy could be diverted. We paused cervical, STI screening and vaccination programme in the initial phase, reopening in a more streamlined manner as the pandemic went out of each wave and adapting again as it went back into a new wave. We undertook a staff survey to assess their views on the new service delivery.Outcomes/ImpactWe conducted a survey of our staff members across all disciplines. There were 34 responses out of 53 staff members. 76.47% agreed that pre reviewing EPR was better for patient care, 88.24% believed that patient flow was improved, 76.47% believed that patients time in the department was reduced due to the virtual reviews and that covid-19 risk was reduced. 80% of doctors felt that doing the virtual reviews was a valuable training experience. 50% believed that there was more time available to deal with complex cases.Innovation and SignificancePre prescribing medications has led to better patient flow and social distancing during clinic. Complex issues, in many cases can be addressed prior to clinic and discussed with senior providers. Stricter adherence to appointment times is more convenient for patients and staff. This system has allowed us to identify patients with complex medical needs and presented opportunity for education and training between senior and junior providers, whilst decreasing Covid-19 risk to provider and patient.