title: Improving notification of sexually transmitted infections: a quality improvement project and planned experiment.
abstract: OBJECTIVE
  Inadequate follow-up of positive sexually transmitted infection (STI) test results is a gap in health care quality that contributes to the epidemic of STIs in adolescent women. The goal of this study was to improve our ability to contact adolescent women with positive STI test results after an emergency department visit.
  
  
  METHODS
  We conducted an interventional quality improvement project at a pediatric emergency department. Phase 1 included plan-do-study-act cycles to test interventions such as provider education and system changes. Phase 2 was a planned experiment studying 2 interventions (study cell phone and patient activation card), using a 2 × 2 factorial design with 1 background variable and 2 replications. Outcomes were: (1) the proportion of women aged 14 to 21 years with STI testing whose confidential telephone number was documented in the electronic medical record; (2) the proportion of STI positive women successfully contacted within 7 days.
  
  
  RESULTS
  Phase 1 interventions increased the proportion of records with a confidential number from 24% to 58% and the proportion contacted from 45% to 65%, and decreased loss to follow-up from 40% to 24%. In phase 2, the proportion contacted decreased after the electronic medical record system changed and recording of the confidential number decreased. Study interventions (patient activation card and study cell phone) had a synergistic effect on successful contact, especially when confidential numbers were less reliably documented.
  
  
  CONCLUSIONS
  Feasible and sustainable interventions such as improved documentation of a confidential number worked synergistically to increase our ability to successfully contact adolescent women with their STI test results.
authors: Division of Pediatric and Adolescent Gynecology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC Cincinnati, OH 45229-3039, USA. jill.huppert@cchmc.org
authors: Jill S
authors: JS
authors: Huppert
authors: Jennifer L
authors: JL
authors: Reed
authors: Jennifer Knopf
authors: JK
authors: Munafo
authors: Rachel
authors: R
authors: Ekstrand
authors: Gordon
authors: G
authors: Gillespie
authors: Carolyn
authors: C
authors: Holland
authors: Maria T
authors: MT
authors: Britto
mesh_terms: D000293:Adolescent; D040421:Cell Phone; D003219:Confidentiality; D018563:Disease Notification / Q000592:standards; D057286:Electronic Health Records; D004636:Emergency Service, Hospital; D058872:Epidemics; D005260:Female; D005500:Follow-Up Studies; D006776:Hospitals, Pediatric; D006801:Humans; D009820:Ohio; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D058996:Quality Improvement / Q000592:standards*; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000517:prevention & control* / Q000635:transmission; D047568:Unsafe Sex / Q000517:prevention & control; D055815:Young Adult