title: New Xpress sexually transmissible infection screening clinic improves patient journey and clinic capacity at a large sexual health clinic.
abstract: BACKGROUND
  In December 2010, a new "express" testing service (Xpress) was implemented alongside routine clinics at a large sexual health clinic. Xpress involved a computer-assisted self-interview, self-collected samples and enrolled nurse staffing. We evaluated the impact of the service on patient journey, staff costs, and clinical capacity.
  
  
  METHODS
  In the first 5 months of Xpress, we calculated the median waiting time and length of stay, staff hours and costs, and utilization. We compared these attributes to the same months in the previous year.
  
  
  RESULTS
  In the Xpress period, 5335 patients were seen (705 in the Xpress clinic, 4630 in routine clinic), 11% more than the 4804 in the before period. Staff hours were 13% greater in the Xpress period compared with the before period (3567 vs. 3151). The cost per patient seen in the Xpress period was lower compared with the before period ($26.79 compared with $28.48). The median waiting time in the Xpress period was 19 minutes (interquartile range, 8-36; 10 in Xpress clinic and 17 in routine clinics) compared with 23 in the before period (P < 0.01). The median length of stay in the Xpress period was 40 minutes (interquartile range, 27-58; 21 in Xpress clinic and 40 in routine clinics) compared with 43 in the before period (P < 0.01). The utilization rates were 67% in the Xpress period (40% in the Xpress clinic and 74% in routine clinics) compared with 76% in the before period (P < 0.01).
  
  
  CONCLUSIONS
  The Xpress clinic improved the patient journey, and although not fully used, more patients were seen overall in the clinic with minimal additional costs. Marketing of the Xpress clinic is underway.
authors.affiliation: Sydney Sexual Health Centre, South East Sydney Local Health District, Sydney, Australia. Vickie.knight@sesiahs.health.nsw.gov.au
authors.forename: Vickie
authors.initials: V
authors.lastname: Knight
authors.forename: Nathan
authors.initials: N
authors.lastname: Ryder
authors.forename: Rebecca
authors.initials: R
authors.lastname: Guy
authors.forename: Heng
authors.initials: H
authors.lastname: Lu
authors.forename: Handan
authors.initials: H
authors.lastname: Wand
authors.forename: Anna
authors.initials: A
authors.lastname: McNulty
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D000554:Ambulatory Care Facilities / Q000191:economics; D001315:Australia / Q000453:epidemiology; D003365:Costs and Cost Analysis; D003695:Delivery of Health Care; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D017064:Process Assessment, Health Care; D057566:Self Report; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D013997:Time Factors; D016526:Workload / Q000191:economics; D055815:Young Adult