Evaluation of a Testing-Only “Express” Visit Option to Enhance Efficiency in a Busy STI Clinic

Shamos, Sara J.; Mettenbrink, Christie; Subiadur, Julie; Mitchell, B.; Rietmeijer, Cornelis A.

doi:10.1097/olq.0b013e31815ed7b2

Cited by 40 publications

(43 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the Denver study, it had declined to 46 min and 52 min in the ETS from 105 min and 85 min in comprehensive routine visits among female and male clients respectively. 14,15 Our study showed no substantial difference in testing for or detection of chlamydia before and after ETS for low-risk clients. However, in Denver Metro Health Clinic, the detection of chlamydia was 2.4 times higher among males and 1.7 times higher among females when comparing comprehensive to express visits; the Sydney study did not examine testing or diagnosis rates of these STIs in their study.…”

Section: Discussionmentioning

confidence: 88%

“…However, in Denver Metro Health Clinic, the detection of chlamydia was 2.4 times higher among males and 1.7 times higher among females when comparing comprehensive to express visits; the Sydney study did not examine testing or diagnosis rates of these STIs in their study. 14,15 The prevalence of chlamydia is~4.6% in heterosexuals under 29 years old in Australia. 16 If ETS had not been introduced, some of these individuals may not have been seen, due to clinic capacity, and this would constitute a missed opportunity to screen.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

An evaluation of an express testing service for sexually transmissible infections in low-risk clients without complications

Gamagedara¹,

Dobinson²,

Cummings³

et al. 2014

Sex. Health

View full text Add to dashboard Cite

Abstract. Background: One effective way of reducing the prevalence of sexually transmissible infections (STIs) in a population is ensuring easy access to clinical services and screening of populations at high risk of STIs, including HIV. We aimed to describe the features of clients using the express testing service (ETS) and the overall impact on the service. Methods: This retrospective cross-sectional study involved all clients attending the walk-in triage service at Melbourne Sexual Health Centre before the introduction of ETS in 2009 and after ETS (2011 and2012). Results: There were 32 720 and 82 265 consultations before and after ETS respectively. The ETS saw 4387 (9%) of 55 648 consultations (excluding appointments and results), giving rise to a fall in the proportion of lower-risk clients having full consultations (from 53% to 50% of consultations; P < 0.001). The consultations testing for HIV and chlamydia (Chlamydia trachomatis) were marginally higher (HIV: 48% v. 47%, P = 0.017; chlamydia: 70% v. 68%, P = 0.015) with ETS. Young (26 v. 27 years) females (38% v. 34%) utilised the ETS more (P < 0.001). The time taken for consultation and the total time spent in the clinic was significantly decreased during the ETS period (from 25 min to 6 min for consultation time and from 59 min to 29 min for total clinic time; P < 0.001). Conclusions: The data suggest that fast-track services such as ETS are effective in increasing access for higher-risk individuals while streamlining screening of asymptomatic low-risk clients.

show abstract

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

An evaluation of an express testing service for sexually transmissible infections in low-risk clients without complications

Gamagedara¹,

Dobinson²,

Cummings³

et al. 2014

Sex. Health

View full text Add to dashboard Cite

show abstract

“…To address this issue, we implemented "express" testing, which is an alternate testing protocol that (1) uses non-invasive testing, (2) relies on less intrusive sexual health historytaking, and (3) reduces HIV pre-test risk reduction counselling (Knight et al, 2013;Rukh et al, 2014;Shamos et al, 2009). To assist others who may wish to replicate our approach, herein, we detail our model of express testing, which is unique from those previously created.…”

Section: Introductionmentioning

confidence: 95%

“…More persons now seek testing, but without corresponding increases in service time or human resources in STI clinics (Heijman et al, 2007;Knight et al, 2013;Rukh et al, 2014;Shamos et al, 2009). Consequently, some individuals who attend these clinics are unable to obtain testing due to either long wait-times or capacity issues -with capacity issues occurring when the number of patients who present for care exceeds the number that can be seen based on the healthcare professional staffing number or compliment on a given day (Heijman et al, 2007;Knight et al, 2013;Rukh et al, 2014).…”

Section: Introductionmentioning

confidence: 97%

“…Globally, clinics that provide testing and treatment for sexually transmitted infections (STIs), including gonorrhea, chlamydia, syphilis, and HIV, have become increasingly unable to address service demands (Heijman et al, 2007;Knight et al, 2013;Rukh et al, 2014;Shamos et al, 2009). More persons now seek testing, but without corresponding increases in service time or human resources in STI clinics (Heijman et al, 2007;Knight et al, 2013;Rukh et al, 2014;Shamos et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

“Express testing” in STI clinics: extant literature and preliminary implementation data

O’Byrne

Phillips

Campbell

et al. 2016

Applied Nursing Research

View full text Add to dashboard Cite

Improving care for sexually transmitted infections

Rietmeijer

2019

J Intern AIDS Soc

View full text Add to dashboard Cite

Introduction Rising rates of reported sexually transmitted infections (STIs) in the US and Europe are a public health priority and require a public health response. The diagnosis and treatment of STIs have been the cornerstone of STI control and prevention for many decades and, historically, publicly funded STI clinics have played a central role in the provision of STI care. Innovations in non‐invasive diagnostic techniques, especially nucleic acid amplification tests in the mid‐1990s, have facilitated the expansion of STI testing and treatment outside traditional STI clinics, including primary care, family planning, school‐based health, outreach, corrections, emergency departments and HIV prevention and care settings. As a result, the continued need for categorical STI clinics has been debated. In this Commentary, we discuss how practice can be improved at each level of STI care. Discussion STI practice improvement plans should be tailored to the strengths of each care setting. Thus, in primary care, the focus should be on improving STI screening rates, the provision of hepatitis B and human papillomavirus vaccines and, in jurisdictions where this is legal, expedited partner therapy for gonorrhoea and chlamydia. Extragenital (pharyngeal and rectal) testing for gonorrhoea and chlamydia should be available in settings serving populations more vulnerable to STI acquisition at these anatomical sites, including men who have sex with men. In family planning settings with a mostly female patient population, there are opportunities to serve male partners with both contraceptive and STI services. STI screening rates can also be improved in other settings serving populations at increased risk for STIs, including school‐based clinics, emergency departments, correctional health facilities and providers of HIV care and prevention. These improvements are predominantly logistical in nature and not dependent on extensive STI clinical expertise. While some providers in these settings may have the clinical knowledge and skills to evaluate symptomatic patients, many do not, and STI speciality clinics must be available for consultation and referral and evolve from “safety net” providers of last resort to STI centres of excellence. Conclusions A tailored practice improvement plan can be envisioned to achieve an optimally functioning STI care continuum.

show abstract

Evaluation of a Testing-Only “Express” Visit Option to Enhance Efficiency in a Busy STI Clinic

Abstract: The triage system at DMHC effectively selects clients at highest risk for STI and increases clinic efficiency.

Cited by 40 publications

References 7 publications

An evaluation of an express testing service for sexually transmissible infections in low-risk clients without complications

An evaluation of an express testing service for sexually transmissible infections in low-risk clients without complications

“Express testing” in STI clinics: extant literature and preliminary implementation data

Improving care for sexually transmitted infections

Contact Info

Product

Resources

About