Quality Improvement Goes Viral: South Carolina’s New STD Patient Management System
to better manage STD testing and clinic wait times
the Fast Track model to get clinic clients tested in a more efficient manner
average clinic wait time from approximately 1 hour to 21 minutes
135 asymptomatic patients who had STDs or HIV infection during the first 6 months of Fast Track use
Sexually transmitted diseases (STDs) cost the United States an estimated $15.3 billion annually and can increase the risk for other health conditions, including HIV infection. Testing and treating individuals for STDs can reduce their risks for acquiring or spreading HIV.
Among US states, South Carolina has one of the five highest rates of gonorrhea and chlamydia. Historically, South Carolina residents had long wait times at local STD clinics, and the clinics didn’t have enough nursing staff to see patients in a timely manner. In addition, when patients who had no symptoms asked to be tested for an STD, they had to complete a full appointment with a nurse; there was no procedure for testing them quickly. South Carolina public health administrators knew there had to be a better way to manage STD testing that smartly used non-nursing resources and reduced clinic wait times.
In 2011, the Public Health Foundation, a national nonprofit organization, provided South Carolina Department of Health and Environmental Control staff with training in quality improvement to equip the health department to begin using quality improvement tools and methods to strengthen the effectiveness of all of its administrative and programmatic initiatives. The South Carolina Department of Health and Environmental Control made the decision to focus on patient wait times and ultimately designed the Fast Track program, which used nonnursing clinic staff to test asymptomatic clients for STDs.
The South Carolina Department of Health and Environmental Control pilot-tested this new model in three different counties and
- Reduced client wait times
- Increased staff morale
- Allowed clinic staff to identify new STD cases
After achieving positive results in the pilot test sites, the South Carolina Department of Health and Environmental Control launched Fast Track in STD clinics statewide. In the first six months of statewide deployment—
- 135 new STD cases, including 12 cases of HIV, were identified among 1,500 clients without symptoms
- Clinic wait times for Fast Track clients averaged 21 minutes, compared with 60-minute wait times before Fast Track was implemented
As a result of the successful use of quality improvement techniques to improve STD testing, the South Carolina Department of Health and Environmental Control is now applying similar techniques to its Field Delivered Therapy program, in which a single dose protocol of oral medication to treat certain STDs is provided by a public health worker in the field.
To spread the word about the success of Fast Track, the Public Health Foundation and the South Carolina Department of Health and Environmental Control together created three educational videos about the quality improvement experience. The videos are available online at www.phf.org/SCQIvideosExternal.
Publication date: 04/08/2013
The information in Public Health Practice Stories from the Field was provided by organizations external to CDC. Provision of this information by CDC is for informational purposes only and does not constitute an endorsement or recommendation by the US government or CDC.