TY - JOUR
T1 - Using Provider Incentives and an Opt-Out Strategy in a Successful Quality Initiative to Increase Chlamydia Screening
AU - Elattma, Ahmed
AU - Laves, Ellen
AU - Taber, Bret
AU - Karvonen, Kayla L.
AU - Herrera, Maria Christina
AU - Bakken, Eliza Hayes
N1 - Publisher Copyright:
© 2020
PY - 2020/6
Y1 - 2020/6
N2 - Background: Chlamydia trachomatis (CT) is a highly prevalent sexually transmitted infection in adolescents that can lead to serious complications. San Francisco has one of the highest rates of CT infections in the United States. At baseline, screening rates at the Children's Health Center were significantly below national and network levels. This project aimed to increase screening rates for female patients age 16–24 from 29.2% to 44% in an 18-month period. Methods: The organization engaged providers, residents, and nursing staff to understand the root causes and choose the screening approach. The following strategies were used to implement this approach in primary and urgent care: (1) universal urine collection, (2) provider and staff education, and (3) adoption of faculty Maintenance of Certification (MOC) credit and resident physician financial incentives. Results: The annual screening rate for CT in primary care female patients 16–24 years old increased from 29.2% to 61.5% in 18 months, and improved to 71.2% one year after the project. Screening rates for female patients over age 15 seen in the colocated urgent care also increased significantly. The research team found no instances of false positive results and had 4 positive results in high-risk patients who initially reported abstinence. Conclusions: The intervention design and engagement of stakeholders with incentives was associated with significant and sustainable improvements in the CT screening rate for female adolescent primary care patients. This work shows how universal opt-out screening can be a sustainable and effective method to address common barriers to increasing screening for CT in adolescents.
AB - Background: Chlamydia trachomatis (CT) is a highly prevalent sexually transmitted infection in adolescents that can lead to serious complications. San Francisco has one of the highest rates of CT infections in the United States. At baseline, screening rates at the Children's Health Center were significantly below national and network levels. This project aimed to increase screening rates for female patients age 16–24 from 29.2% to 44% in an 18-month period. Methods: The organization engaged providers, residents, and nursing staff to understand the root causes and choose the screening approach. The following strategies were used to implement this approach in primary and urgent care: (1) universal urine collection, (2) provider and staff education, and (3) adoption of faculty Maintenance of Certification (MOC) credit and resident physician financial incentives. Results: The annual screening rate for CT in primary care female patients 16–24 years old increased from 29.2% to 61.5% in 18 months, and improved to 71.2% one year after the project. Screening rates for female patients over age 15 seen in the colocated urgent care also increased significantly. The research team found no instances of false positive results and had 4 positive results in high-risk patients who initially reported abstinence. Conclusions: The intervention design and engagement of stakeholders with incentives was associated with significant and sustainable improvements in the CT screening rate for female adolescent primary care patients. This work shows how universal opt-out screening can be a sustainable and effective method to address common barriers to increasing screening for CT in adolescents.
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U2 - 10.1016/j.jcjq.2020.03.003
DO - 10.1016/j.jcjq.2020.03.003
M3 - Article
C2 - 32386995
AN - SCOPUS:85085133606
SN - 1553-7250
VL - 46
SP - 326
EP - 334
JO - Joint Commission Journal on Quality and Patient Safety
JF - Joint Commission Journal on Quality and Patient Safety
IS - 6
ER -