| Popis: |
Background Unity Sexual Health in Bristol UK, re-designed its service to improve access and delivery of care. This includes a Panther (Hologic Inc) system at the point of care to provide rapid STI tests, allowing Nucleic acid amplification testing results for STIs including gonorrhoea and chlamydia to be available within four hours. Previously patients waited over a week for results. Methods A qualitative evaluation running alongside the implementation of the new service, to understand experiences, and inform its iterative development. A total of 21 members of staff and 26 patients were interviewed, and 40 hours of observations conducted of the service in operation, were analysed thematically. Results The new service implementation required co-ordinated changes in practice across multiple staff teams. Patients also needed to make changes to how they accessed the service. Multiple small ‘pilots’ of process changes were necessary to find workable options. This responsive model created challenges for delivering comprehensive training/communication in advance to all staff. However, staff worked together to adjust and improve the new service, and morale was buoyed through observing positive impacts on patient care. Patients valued faster results and avoiding unnecessary treatment. They were willing to drop off samples and return for a follow-up appointment the same/next day, enabling infection-specific treatment in accordance with test results thus improving antimicrobial stewardship. Conclusions Implementation of service changes to improve access and delivery of care in the context of stretched resources can pose challenges for staff at all levels. Early evaluation of pilots of process change, provide opportunities for prompt feedback enabling adjustment, is valued. Visibility to staff of positive impacts on patient care is important in maintaining morale. The service was acceptable to patients. |
