Increasing Chlamydia Screening at Sugarhouse Clinic through Workflow Redesign

The AAFP, USPSTF, ACOG, AAP, and CDC recommend annual Chlamydia screening of asymptomatic sexually active women ages 14-24. National Chlamydia (CT) screening rates average at 45% for commercial insurance and 57% for Medicaid. The institutional goal for the University of Utah (U of U) community clinics is 50.4%. The rate of annual Chlamydia screening at Sugarhouse clinic (SHC) was 51.5% in women 16-24 at the start of the fiscal year when all patients assigned a PCP at SHC were counted. This clinic quality improvement project illustrates a very valuable concept that is commonly encountered in CQI projects: the need to redesign work flows versus adapt health care systems to work within current work flows to improve quality. Constant workflow redesign can result in "innovation fatigue", especially if each new workflow redesign adds new steps to the current processes in place to care for patients. One solution to avoid innovation fatigue amongst providers without compromising quality would be to redesign systems, not work flows, to work within work flows that already exist. The HM item solution to message patients directly about their overdue screening tests seems like a good one, but it should be noted that providers are unlikely to participate in population health (PH) management efforts like these unless they are provided with compensated time to perform them. Better yet, automate these PH management efforts entirely.