Improving screening rates for sexually transmitted and blood-borne infections among patients initiating care in a low-barrier addiction medicine clinic: a quality improvement project.

Abstract

Despite a high prevalence of sexually transmitted and blood-borne infections (STBBIs) among patients with substance use disorders, screening rates in addiction medicine settings are often low. At baseline in our addiction clinic, only 65% of patients were offered screening and only 6% completed screening blood work. This quality improvement project aimed to improve the rate of STBBI screening among new intakes in our clinic by 50%.Interventions included the creation of clinic screening guidelines to include annual screening for all patients for HIV, hepatitis B and C, syphilis, gonorrhoea and chlamydia. Additionally, an on-site phlebotomist was hired. These interventions increased screening rates to an average of 33% with the greatest improvement seen after the addition of the phlebotomist. We found that implementing a bundle of interventions improved rates of screening and detection of STBBIs in a low-barrier addiction medicine clinic. Comprehensive infection prevention, screening and linkage-to-treatment protocols are needed to close gaps in care for this vulnerable patient population.