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MINUTES-Draft <br />ORANGE COUNTY BOARD OF HEALTH <br />September 28, 2016 <br />S:\Managers Working Files\BOH\Agenda & Abstracts\2016 Agenda & Abstracts/ September Page 2 <br />Various staff shared abbreviated versions of some of their recent presentations. Below are <br />some of the highlights. <br /> <br />Andrea Mulholland – Clinic Staff Adherence to the CDC’s STD Treatment Guideline: A <br />QI Initiative in a Local Health Department <br /> <br />The OCHD has adhered more closely to state standards versus the CDC’s <br />guidelines. Ms. Mulholland’s objective was to assess clinic staff adherence to <br />CDC’s STD Treatment Guidelines for treatment and follow up of chlamydia, <br />gonorrhea and syphilis which are the three most prevalent reportable STDs. Low <br />rates of patient return for rescreening were determined; although, OCHD had <br />high levels of adherent treatment. Various factors were the provider, patient and <br />organizational. The data collection methods included a chart review of clients <br />screened and treated at both OCHD clinics during the period of July 1, 2014 <br />through July 1, 2015 and a survey designed via Qualtrics that was sent to clinic <br />staff on February 3, 2016. <br /> <br />Based on the results, discussion emerged including having high levels of <br />guideline adherence by OCHD staff for treatment of chlamydia and gonorrhea <br />and a lack of provider awareness/need for staff education. Two out of 58 clients <br />with chlamydia were not able to be reached for treatment. There was a need for <br />strategies for communicating with difficult to reach populations. It was also noted <br />that there was 100% treatment rates for syphilis. As a result of the findings, five <br />recommendations were made: <br /> <br />1. Staff education – OCHD staff have knowledge of CDC’s guidelines, <br /> less knowledge of North Carolina Administrative <br /> Code (NCAC §46 0214 & §41A 0204); <br /> Educate all levels of employees; <br /> More staff engagement and appointment availability. <br /> <br />2. Patient Education – Different types of staff provide STD services; <br />Regardless of staff type: concise and consistent patient <br />education; <br />Timeframe results will be ready, risk reduction and need <br />for 3 month rescreen. <br /> <br />3. Technology – Effectively used for STD risk reduction and education; <br />Harness power of technology with guidance from <br />authorities to communicate with hard to reach and <br />anonymous clients; <br />Text message, web based notification and email <br />reminders. <br /> <br />4. Ongoing QI – Evaluating numbers of STDs and level of adherent therapy; <br /> Improve efficiency, reduce errors, improve practice; <br /> Communicate with front line staff to stimulate shared <br /> decision making <br /> <br />5. Public policy and funding – Public health spending (NC:$14.16/person, <br /> US:$30.61/person);