Table 1

PDSA cycle outcome

Clinical servicesCommunity referral systemCommunity outreach and engagement
  • Ensure patient care continues with recommended COVID-19 safety precautions in place.

  • Maintain patient access to navigation support and linkage to needed resources.

  • Offer virtual youth engagement opportunities to strengthen patient connections and supports despite limited in-person outreach.

  • Discontinue walk-in HIV/STI testing.

  • Offer free home HIV testing option.

  • Develop call-in testing protocol with assigned testing times.

  • Begin preappointment COVID-19 screening.

  • Increase use of telehealth as appropriate.

  • Shift to providing virtual navigation support.

  • Obtain remote access to electronic health record.

  • Initiate use of online referral management systems to improve linkages and tracking.

  • Increase use of phone, text and email outreach.

  • Leverage digital platforms to share youth-friendly resources.

  • Increase frequency of youth engagement events.

  • Increase incentives for youth participation in engagement events.

  • Transition to virtual engagement, including monthly youth advisory boards on Zoom and Q&A sessions on Facebook Live and Instagram.

  • Schedule weekly virtual leadership meetings to review operations and discuss plans for continuous improvement.

  • Monitor testing and appointment numbers to ensure patient needs met.

  • Track case finding rates for STIs/HIV.

  • Record virtual outreach experiences with each patient interaction.

  • Assess challenges reaching youth by phone and test process improvements to overcome.

  • Track patient resource needs monthly and use to inform updates to resource directory.

  • Track patient referrals, number of outreach attempts and patients lost to follow-up.

  • Obtain youth feedback during virtual meetings and via social media and use to inform topics for online Q&A sessions and youth forums.

  • Track analytics of new social media efforts.

  • Measure changes in the types of referrals from youth resource navigator.

  • Track board meeting attendees, social media postings and social media engagement metrics.

  • Hold trainings and issue guidelines for staff on use of technology during COVID-19.

  • Develop innovative and socially distant HIV/STI testing events with community partners.

  • Increase dissemination of health education materials on social media.

  • Increase collaboration with providers to facilitate connections with patients during visits.

  • Update online resource directory to highlight telehealth options and resources of highest need during COVID-19.

  • Change patient intake form to include email address and best time to contact.

  • Disseminate COVID-19 resources in new virtual newsletters.

  • Strengthen partnerships with agencies providing services to support online referrals.

  • Hold monthly youth advisory board meetings on COVID-19 related topics to meet youth needs.