Staff views of an opportunistic chlamydia testing pilot in a primary health organisation

Abstract

INTRODUCTION: The Auckland chlamydia pilot was one of three pilots funded by the Ministry of Health to trial implementation of the 2008 Chlamydia Management Guidelines prior to national roll-out. AIM: To assess what elements in the testing programme pilot worked best for staff and to determine how an opportunistic testing programme could be better configured to meet staff needs and preferences. METHODS: A staff survey listed key chlamydia testing tasks in chronological order, and service interventions supporting these tasks. Staff were asked to rate each task on its difficulty prior to the pilot, and then on the difference the pilot had made to each task. They were also asked to rate service interventions on their usefulness during the pilot implementation. RESULTS: The survey had a response rate of 94%. The testing tasks posing the greatest difficulties to staff were those involving patient interactions (41%) and management of follow-up (52%). About 70% of staff felt tasks were improved by the pilot. Staff considered the three most useful service interventions to be a chlamydia-specific template created for the practice management system, provision of printed patient resources, and regular team discussions with other staff. DISCUSSION: A significant proportion of staff reported difficulties with routine tasks required for opportunistic testing for chlamydia, highlighting the need to involve staff during programme design. Practice nurse–led approaches to future opportunistic testing programmes should be considered as nurses had a more positive response to the pilot and nurse-led approaches have been shown to be successful overseas. KEYWORDS: Chlamydia trachomatis; general practitioners; health care surveys; medical receptionist; nurses; pilot projects; primary health care; staff development

'He said he had been out doing the traffic': general practitioner perceptions of sexually transmitted infection and HIV testing strategies for men

“…These findings echo those of other work on men's health and patient engagement. 1,6,[8][9][10][11][12][13][14][15][16][17][18]24 Doctors in this study also stated that asking the right questions can be difficult. The difficulty extends to the best language or way to phrase the question, how not to be offensive, and the best time to ask…”

“…High rates of chlamydia, multiresistant gonorrhoea and the risk of syphilis and HIV mean sexually transmitted infections (STIs) are a major problem for the New Zealand health sector. [4][5][6][7][8][9] Increasing appropriate men's STI and HIV test rates by GPs is a key preventive method to reducing transmission of infection. 5,9,[10][11][12] This is because testing leads to immediate access to treatment in primary care for common infections, such as chlamydia, and as a point of entry to referral for HIV infections.…”

Contact tracing for sexually transmitted infections in Aotearoa New Zealand: a review of clinician-notified gonorrhoea and syphilis data

“…[4][5][6] However, when strategies are implemented to support clinicians to more effectively undertake contact tracing (eg with training, processes around documentation and follow up), this aspect of STI management can be significantly improved (see Supplementary Table S1). [7][8][9][10][11] In addition to effective case management, surveillance also plays an important role in reducing STI prevalence. 12 Surveillance is the ongoing, systematic collection, analysis, interpretation and dissemination of data, and is an important way to measure disease burden, monitor trends and identify disease outbreaks to inform public health planning, policy, strategies and allocation of health resources.…”

Editorial: From the patient's perspective

“…McKernon and Azariah evaluate a pilot programme aimed at implementing the chlamydia management guidelines. 5 They identify areas of difficulty encountered by all members of the primary care team, highlighting the need to include staff input when designing programmes.…”