Improving Effective Chlamydia Screening for Women at Risk at a Rural Family Planning Clinic

Area of Science:

• Public Health
• Nursing
• Quality Improvement

Background:

• Chlamydia is the most common bacterial sexually transmitted infection (STI) in the US, with 1.7 million annual infections and $691 million in lifetime medical costs.
• Effective care for chlamydia infection is crucial for preventing long-term health consequences and reducing healthcare expenditures.

Purpose of the Study:

• To enhance effective care for women at risk of chlamydia infection in a rural family planning clinic.
• To achieve an 80% effective care rate within a 90-day period.

Main Methods:

• Implementation of the Plan-Do-Study-Act (PDSA) quality improvement (QI) process over four 2-week cycles.
• Iterative collection and analysis of qualitative and quantitative data to inform tests of change.
• Standardized risk assessment protocol development and implementation.

Main Results:

• Effective care rates improved significantly from a baseline of 42% to 81%.
• Average patient visit time decreased from 38 minutes to 23 minutes.
• Chlamydia positivity rate doubled (from 3 to 6 positive tests), and chlamydia test billing increased by 32%.

Conclusions:

• The QI project successfully improved effective chlamydia care in a rural family planning setting.
• Standardized risk assessment effectively reduced patient visit times.
• QI initiatives targeting national STI screening standards are feasible, low-cost, and high-impact in rural health clinics.