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Presentation synopsis:

BHIVA late presentation audit: What can we learn?

The 2016 British HIV Association (BHIVA) national audit showed that in PLWH presenting late (CD4<350), around half had missed opportunities to test for HIV in the years before diagnosis. In response, BHIVA decided a new approach to managing late diagnoses was needed to improve HIV testing. A pilot process was developed by which all new late diagnoses were reviewed and cases where both missed opportunities to test were found and significant harm occurred were designated as a ‘serious incident’ (SI), with root-cause analysis undertaken. This approach – making late HIV diagnosis a patient safety issue – has the potential to increase testing and reduce late diagnosis.

Speaker biography:

David Chadwick is an Infectious Diseases specialist at James Cook University Hospital in Middlesbrough. He went to school in North Yorkshire, qualified from Cambridge University Medical School in 1991 and trained in Infectious Diseases in Cambridge and Singapore, after completing a PhD in HIV gene therapy in 1999. He has worked in the North East of England for the past 16 years, and developed the Newcastle University Medical School Infectious Diseases module. He sits on the British HIV Association (BHIVA) Executive Committee and has chaired the BHIVA Audit and Standards subcommittee since 2016.

He is currently also overseeing the new BHIVA opportunistic infection guidelines. He has clinical and research interests in HIV, central nervous system infections and patient quality and safety initiatives. He has taken part in a large number of clinical trials and other studies in HIV, as well as antimicrobial and vaccine studies. His main personal research interests include management of HIV in developing countries, viral hepatitis co-infection and developing clinical decision support systems (software in electronic patient records) to improve blood-borne virus testing in primary care and other health facilities.


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