Developing and Improving a Fast Track STD Services Program in Chicago STD Clinics

Background:
Fast track STD services can increase the clinical capacity of STD clinics. In 2005, CDPH initiated STD fast track services pilot programs in two municipal STD clinics.

Objective:
To develop, implement, evaluate, and improve a fast track STD program.

Method:
CDPH staff developed program protocols, training materials, and a screening questionnaire used to assess patient symptoms, demographics, and behavioral risks. We compared fast track service utilization, test and treatment results of persons with CT, GC, and syphilis from November 2005 through December 2006 in two CDPH STD clinics. We conducted focus groups with CDPH staff to identify barriers and facilitators of fast track services program implementation and effectiveness.

Result:
Of 1,115 patients presenting to Clinic A from November to December 2006, 212 (19%) were provided fast track services. Of 8,247 patients presenting to Clinic B from January-December 2006, 63 (0.7%) were provided fast track services. Among fast-track patients, chlamydia was identified in 10(4.8%) patients and syphilis in 5(2.4%) patients in Clinic A; and chlamydia was identified in 5(7.9%) patients in Clinic B; no gonorrhea was identified among fast track patients. All patients with STDs were asymptomatic, and were treated following the initial visit. Staff focus groups identified barriers to fast track services delivery that included differences in patient perceptions of fast track services and variability in acceptance. Recommendations for program enhancement included improved clinic promotional materials, additional staff training, and revised training materials and operational protocols.

Conclusion:
Implementation of fast track STD services was feasible and effective at expanding clinic capacity; however utilization rates differed by clinic during the pilot period. Barriers to effective implementation of fast track services can be overcome to improve service utilization in STD clinics.

Implications:
Understand the development and implementation of fast track STD services program utilizing existing STD clinic staff.