• Herschel Knapp, Hildi Hagedorn, and Henry D Anaya.
• U.S. Department of Veterans Affairs, Health Services Research and Development, Los Angeles, CA, USA Herschel.Knapp@va.gov.
• Int J STD AIDS. 2014 Oct 1;25(12):837-43.

AbstractIn 2008, nurse-administered HIV oral rapid testing (RT) was introduced at the Veterans Affairs Primary Care Clinic in Downtown Los Angeles. Analysis at five years revealed variable yet increasing rates of HIV RT at that facility despite the fact that no post-launch support was provided by the implementation team. Qualitative interviews among stakeholders conducted at five years revealed the pre-existing implementation practices endemic to this clinic that facilitated this unprecedented success (e.g. history of positive quality improvement implementations, leadership support, clinician involvement at each step of the process to facilitate empowerment, ownership and feasible customisation of the implementation, cohesive communication among clinicians and leadership, training, efficient supply pathway, progressive performance feedback and ongoing encouragement).© The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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