264038 Monitoring STD screening as part of Continuous Quality Improvement (CQI) in public health primary care clinics for populations with health disparities in San Francisco

Monday, October 29, 2012

Priscilla Lee Chu, DrPH, MPH , Population Health and Prevention, San Francisco Department of Public Health, San Francisco, CA
Israel Nieves-Rivera , Php, SFDPH, San Francisco, CA
Noah Carraher , HIV Prevention Section, SFDPH, San Francisco, CA
Deborah Borne, MD , COPC, SFDPH, San Francisco, CA
Winnie Tse , COPC, SFDPH, San Francisco, CA
Tomás Aragón, MD, DrPH , Community Health Epidemiology, San Francisco Department of Public Health, San Francisco, CA
Background. The San Francisco Department of Public Health (SFDPH) is a national Program Collaboration and Service Integration (PCSI) demonstration project site. SFDPH also provides care in 15 Community-Oriented Primary Care (COPC) clinics. Using national guidelines and local epidemiology, the department is revising our screening guidelines for STDs. We assessed a COPC baseline screening rate for two populations with the clearest STD guidelines – young women under 25 and men living with HIV/AIDS (LWHA) – before the guidelines were implemented for Continuous Quality Improvement (CQI).

Methods. We used medical record data to pull patients who had at least one COPC visit in the past two years. We created two datasets: young women under 25 and men LWHA. For young women, we looked at testing rates for Chlamydia, gonorrhea, and HIV. For men LWHA, we calculated testing rates for syphilis, Chlamydia, and gonorrhea.

Results. Of the 55489 active patients, 3432 (6%) were young women 13-24 years old; testing for HIV (27%) was lower than for STDs (62% for Chlamydia, 60% for gonorrhea). Highest positive rate was for Chlamydia (N=85, 4%).

There were 1602 (3%) men LWHA. Testing and positivity were highest for syphilis (62% tested, N=97 positive, 10%).

Conclusions. SFDPH is beginning the process of utilizing registries, data walls, and dashboards as a tool to monitor CQI for preventive services in COPC clinics. We will be coaching health centers and creating STD QI bundles to incorporate clinical guidelines into regular health care maintenance screening.

Learning Areas:
Protection of the public in relation to communicable diseases including prevention or control
Public health administration or related administration
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Public health or related research

Learning Objectives:
Define two populations with health disparities in San Francisco; describe San Francisco public health clinic testing rates for STDs for two populations

Keywords: Community Preventive Services, Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Doctor of Public Health and an epidemiologist. I analyze clinical data for our integrated clinical guidelines.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.