Assess Your Readiness: Engaging Key Stakeholders
Who needs to be on board?
Successfully implementing ED HIV testing requires that key players support the program, understand its need, and know how it will affect patient care in their daily practice. Factors that can help engage key stakeholders include:
- ED leaders support the effort.
- ED physician or leader champions the effort.
- Additional resources are provided, such as staff to conduct the testing or obtain funding.
- ED leadership and clinical staff have a public health orientation—that is, they see public health as part of their mission.
- Hospital CEO is aware of and supports the effort.
- HIV testing in the ED is part of a broader health improvement and prevention effort by the hospital or health system.
- Pilot tests are conducted to assess the idea and demonstrate impact.
- The ED serves a population that is at risk for HIV.
Factors that may make key stakeholders reluctant to support ED HIV testing include:
- Concerns about patient flow.
- Little awareness of the need and relevance of HIV testing in emergency medicine.
- Reliance on ED providers for most aspects of the testing process.
- Difficulty in demonstrating direct clinical benefit.
- Competing priorities in treating patients' chief complaints or other public health issues that may be more pressing for an individual patient.
To engage key stakeholders, consider the following questions:
- Who will champion HIV testing in the ED? Can this person convince ED leadership and clinical staff of the importance and relevance of HIV testing in the ED? Will he or she be able to ensure that the ED adopts the program? Will he or she be able to speak about the program to both internal and external audiences to build broad awareness and support?
- Who needs to be informed and to buy in to having an ED-based HIV testing program in your institution? Does anyone require additional information or data to make the case for HIV testing in this ED?
- Who has resources or important perspectives to contribute to the effort?
- Who needs to be involved in program design and decision making?
- Have they been contacted?
- Do they have specific expectations about the program?
- What are their concerns?
This chart serves as a tool for you to identify key stakeholders and track engagement and communication:
|
Key Stakeholder Engagement |
Informed/ |
Resources / |
Design/ |
Contacted? |
Expectations |
Concerns |
| ED Leadership | ![]() |
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| ED Physicians | ![]() |
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| ED Nurses | ![]() |
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| ED Registration and Triage | ![]() |
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| Laboratory | ![]() |
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| Health Department | ![]() |
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| Infectious Disease Leadership and Clinical Staff | ![]() |
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| HIV Counseling and Testing Services | ![]() |
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| Hospital Administration | ![]() |
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| Academic Research Department | ![]() |
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| Risk Management | ![]() |
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| Community-based Organizations | ![]() |
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| Social Services | ![]() |
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| Mental Health Leadership and Staff | ![]() |
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| Who else? | ![]() |
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Next Steps:
- For each area that has not been contacted, when do you plan to do so?
- For any concerns, is there information or resources that would diminish those concerns? Plan to make presentations to provide this information. See Making the Case.
- Think about how the program design can address and incorporate key players' viewpoints and contributions, so that the program's benefit is experienced quickly, even if on a small scale. See Operational Flow.
- What resources—human, financial, space, and equipment—are currently available among stakeholders to support implementation? What are the gaps and who will address them?
For more information on potential roles and perspectives, go to Key Players.
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