Implementing a rapid sexual health testing, diagnosis and treatment service: Qualitative evaluation
PHE ePoster Library. Horner P. Sep 12, 2019; 274402; 203
Assoc. Prof. Patrick Horner
Assoc. Prof. Patrick Horner
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Abstract
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Abstract Introduction
Unity Sexual Health in Bristol re-designed its service to improve access, delivery of care and reduce unnecessary antibiotic use. This includes a Panther(Hologic Inc) system at the point of care to provide test results for gonorrhoea(GC), chlamydia(CT) and trichomonas after four hours for both symptomatic and asymptomatic patients. Previously patients waited over a week for CT/GC results.
Methods
A qualitative evaluation alongside the implementation of the new service, to understand experiences, and inform its iterative development. Fourteen semi-structured interviews with staff and patients, and 25 hours of observation of the service, were analysed thematically.
Results
The new service implementation required co-ordinated changes in practice across multiple staff teams. Patients also needed to make changes to how they accessed the service. Multiple small ‘pilots' of process changes were necessary to find workable options. This responsive model created challenges for delivering comprehensive training/communication in advance to all staff. However, staff worked together to adjust and improve the new service, and morale was buoyed through observing positive impacts on patient care. Patients valued faster results, and avoiding unnecessary treatment. They were willing to drop off samples and return for a follow-up appointment the same/next day, enabling infection-specific treatment in accordance with test results thus improving antimicrobial stewardship.Discussion:Implementation of service changes in the context of stretched resources can pose challenges for staff at all levels. Early evaluation which provides opportunities for prompt feedback and adjustment is valued. Visibility to staff of positive impacts on patient care is important in maintaining morale. External funding details
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