Improving services for sex partners of chlamydia-infected patients in an HMO

To improve services for sex partners of chlamydia-infected patients (ie, chlamydia partner services [CPS]) at an HMO.

Assessment of current CPS policy, practices, and opinions in Kaiser Permanente Northwest Region (KPNW) and in local health departments, and design, implementation, and evaluation of 4 CPS interventions.

We reviewed KPNW policy documents, conducted focus groups with KPNW clinicians, and did phone interviews with KPNW chlamydia-infected patients and health department disease intervention specialists. We then implemented 3 informational interventions: CPS information was added to the after-visit summary given to patients tested for chlamydia; information on how to test, treat, and counsel chlamydia-infected patients was added to KPNW's electronic clinical-decision tool; and CPS information and a direct link to KPNW's chlamydia screening and treatment guidelines were added to KPNW's Web site. We also organized training for KPNW clinicians to review the roles of CPS and disease intervention specialists. We evaluated intervention uptake and impact by reviewing electronic medical charts, Web site "hits," and posttraining evaluations.

Clinicians and disease intervention specialists reported that KPNW's CPS policy and the roles of disease intervention specialists regarding KPNW patients were unclear. Clinicians and patients wanted more CPS information. Clinicians commonly used the after-visit summary and Web-based CPS information and reported that training improved CPS knowledge. However, none used the clinical-decision tool.

Several simple, centralized informational interventions to improve CPS were feasible and used by KPNW clinicians. These interventions could potentially be used in other settings structured like KPNW.