A Clinic-Based Quality Improvement Initiative to Increase Screening for Gonorrhea and Chlamydia in Adolescents
| Autor: | Martha F. Perry, Elizabeth Walters, Benjamin W. Butler, Bianca A. Allison |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Quality management Adolescent Leadership and Management Gonorrhea 03 medical and health sciences 0302 clinical medicine medicine Humans Mass Screening 030212 general & internal medicine Chlamydia Child business.industry 030503 health policy & services Chlamydia Infections medicine.disease Quality Improvement Annual Screening Ct screening Family medicine Secondary Outcome Measure 0305 other medical science business PDCA Adolescent health |
| Zdroj: | The Joint Commission Journal on Quality and Patient Safety. 47:510-518 |
| ISSN: | 1553-7250 |
| Popis: | Background Universal screening is a strategy for addressing the limitations of risk-based screening for gonorrhea and chlamydia (GC/CT). This quality improvement (QI) initiative aimed to improve GC/CT screening by implementing universal annual screening for all adolescents ≥ 13 years old. Methods At an academic pediatric resident continuity clinic, an interdisciplinary team designed and conducted multiple Plan-Do-Study-Act (PDSA) cycles over one year. The primary aim, and process measure, was to increase the percentage of encounters with screening for GC/CT in the 12 months prior to the encounter to 80%. The secondary outcome measure was rate of detection of GC or CT infection. Further, pulse checks of provider/staff knowledge and adherence were conducted. The balancing measure was denied insurance claims. Results The mean screening rate of 29.2% increased during the project implementation to 65.1% with several bundles of PDSA cycles. There were no cases of gonorrhea detected in the baseline period or implementation period. The case rate of chlamydia was similar during both periods (from 9.7 per 1,000 adolescent encounters to 10.8 per 1,000 adolescent encounters, p = 0.74). There was similarly high provider/staff knowledge about (p = 0.35) and adherence to (p = 0.06) the screening protocol at 6 and 12 months of implementation. There was no increase in percentage of denied insurance claims. Conclusion This QI initiative doubled rates of GC/CT screening with no statistically significant increase in number of cases. |
| Databáze: | OpenAIRE |
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