Healthcare Professionals' Perspectives on the Direct Referral Pathway for Syphilis Management in Western Sydney

Area of Science:

• Public Health
• Infectious Diseases
• Healthcare Management

Background:

• Syphilis incidence is rising globally, leading to preventable complications like congenital syphilis.
• Effective management requires robust referral systems between public health and sexual health services.
• The Western Sydney Local Health District introduced a direct syphilis referral pathway to address these challenges.

Purpose of the Study:

• To explore healthcare professionals' experiences with a direct syphilis referral pathway.
• To assess the pathway's perceived impact on clinical outcomes and care coordination.
• To identify facilitators and barriers to effective syphilis management.

Main Methods:

• Qualitative study using semi-structured interviews with 14 clinicians (medical practitioners, registered nurses).
• Interviews were audio-recorded, transcribed, and analyzed using thematic analysis.
• Part of a quality improvement initiative within a local health district.

Main Results:

• The pathway facilitated proactive follow-up, especially for high-risk groups like pregnant women, leading to faster treatment.
• Improved interprofessional communication, defined roles, and digital tools enhanced care coordination.
• Challenges included patient stigma, housing instability, and engagement difficulties despite outreach.

Conclusions:

• The direct syphilis referral pathway improved timeliness, coordination, and equity of care for high-risk patients.
• Stronger collaboration between public health and sexual health services is key for integrated management.
• Ongoing social and structural barriers necessitate complementary supportive interventions.