Using Texting to Improve STD Follow-Up with Clients

Summary

Impact Statement:

Communicable disease (CD) follow-up: Staff let their fingers do the walking using social media to significantly improve the timeliness and effectiveness of client contact and case completion procedures for CD clients.

Summary:

The original purpose of Gallatin County's (Montana) quality improvement (QI) initiative was to decrease the number of sexually transmitted disease (STD) cases that were not contacted for an interview. Upon further analysis of the communicable disease (CD) follow-up procedure, the team found that only 10 out of 208 STD cases had not been contacted for an interview last year. The QI team, consisting of the CD Program manager, the CD public health nurse (PHN), the immunization nurse, and AmeriCorps VISTA, decided to switch the focus of this project to decreasing the time spent contacting and completing case interviews.

After analyzing the current process and input from PHNs in nearby health departments, the team decided that the best way to increase the efficiency of this process was to incorporate texting into the follow-up procedure. The team decided to study chlamydia cases only, in order to keep data collection manageable. The team randomized the control and intervention groups (every other positive case received was sent a text as part of the follow-up procedure) and collected data over the span of 3 months.

From the data collected, it was determined that cases in the intervention group were being completed more quickly than those in the control group. Therefore, the team decided to change the policy to include texting for all reportable diseases requiring follow-up contact with patients.

Organization that conducted the QI initiative:

Gallatin City-County Health Department

Citation:

Tassaro, S. Public Health Quality Improvement Exchange. Using Texting to Improve STD Follow-Up with Clients. Fri, 06/12/2015 - 12:39. Available at http://phqix.org/content/using-texting-improve-std-follow-clients. Accessed April 18, 2024.

Background and Aim

Planning and Execution Details

QI Implementation:

The team began this project by examining the current approach the CD PHN uses to contact patients with reportable diseases. The team created a process map and brainstormed areas of potential solutions. The CD PHN researched evidence-based practices and contacted a RiverStone Health PHN (Billings, Montana) who uses Facebook and texting in that health department's disease investigation process. The following alternatives were considered: contacting patients via Facebook, sending texts, mailing letters earlier in the process, or changing the order of the phone call and letter. The team determined that texting would be the least time consuming and had the highest potential for impact. The team developed the theory that if they incorporate texting into the current STD follow-up procedure, then interviews and contact case management will be completed more quickly and efficiently.

Focus activities

Screening for diseases and conditions:

Other STDs

Disease Treatment Services:

Other STDs

Data collection, Epidemiology and Surveillance:

Communicable/infection diseases

Reportable diseases

Population-based Primary Prevention :

Sexually transmitted disease counseling

Professional licensure:

Nurses (any level)

QI Methods:

PDCA/PDSA Cycle (Plan, Do, Check/Study, Act)

QI Tools:

Brainstorming

Process maps

QI Tool Documentation:

STD Follow-Up Storyboard.pdf

STD Follow-Up Process Map.pdf

STD Follow-Up Data.pdf

Initiative Dates:

1/1/15 to 3/31/15

Initiative Duration:

Less than 6 months

Methods of evaluation:

The team used the current CD log to randomize the control and intervention groups. They decided to test the theory for positive chlamydia cases only so that the data collection would be manageable. Every other case received a text after the first phone call. The CD log was modified to record when a person was contacted and when they were interviewed. The standard procedure that was used for the control group was to call the patient three times and leave a voicemail each time the patient did not answer. If the patient did not return any of the calls, the CD PHN would then mail a letter to him or her. If the patient answered the phone or called back at any point during the process, the interview would be conducted and the case would be completed. The procedure that the team used for the experimental/intervention group was to call the patient, and if he or she did not answer, the PHN would send the patient a text prompting him or her to call the health department. If the patient did not respond to the text, the nurse would call a second time, leave a voicemail if no answer, then mail a letter if there was still no response.

Results

Information about the Community

Information about the Health Department

QI Staff Information

Contact Information of the Submitter

Submission Status:

Completed

Comments

Great story. Have you

Great story. Have you employeed text messaging into any other programs? We are experimenting with it for WIC appointment reminders and HIV follow ups.

Hi Torney,

Our Communicable Disease program also uses texting for GI illnesses and pertussis. We also use it for our Ryan White clients, but only if we have permission to text them.

Thanks for checking out our QI project!

Stefanie Tassaro
Accreditation Coordinator/QI Specialist
Gallatin City-County Health Department
stefanie.tassaro@gallatin.mt.gov

Is there a particular texting

Is there a particular texting program you are utilizing? We are currently brainstorming possible options and appreciate any insight! Thank you.

Bethany Bjorklund RN, BSN
Immunization Nurse
Cerro Gordo County Department of Public Health

Hi Bethany!

Thank you for your question. We do not use a specific texting program, rather we invested in a smart phone for our CD/IZ program. Our nurses use this phone to text clients and help facilitate contact investigation (our landline phones usually show up as "unknown" which may have been why people were hestitant to answer).

I hope this helps and please don't hesitate to contact me if you have further questions.

Thanks!

Stefanie Tassaro
Accreditation Coordinator/QI Specialist
Gallatin City-County Health Department
stefanie.tassaro@gallatin.mt.gov

Using Texting to Improve STD Follow-Up with Clients

Summary

Background and Aim

Planning and Execution Details

Results

Information about the Community

Information about the Health Department

QI Staff Information

Contact Information of the Submitter

Comments

Great story. Have you

Hi Torney,

Is there a particular texting

Hi Bethany!

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Using Texting to Improve STD Follow-Up with Clients

Summary

Background and Aim

Planning and Execution Details

Results

Information about the Community

Information about the Health Department

QI Staff Information

Contact Information of the Submitter

Comments

QI Spotlight