Research Mentor(s): Rachel Solnick, IHPI Fellow & Emergency Medicine Attending
Research Mentor School/College/Department: Institute for Healthcare Policy and Innovation, Michigan Medicine
Presentation Date: Thursday, April 22, 2021
Session: Session 4 (2pm-2:50pm)
Breakout Room: Room 12
Background: Emergency Departments (ED) are the primary source of healthcare for many patients diagnosed with sexually transmitted infections (STIs). Expedited partner therapy (EPT), treating the partner(s) of patients with STIs without an exam, is an evidence-based practice for individuals who might not otherwise seek care. Methods: We conducted semi-structured, open-ended interviews with ED medical directors and key medical personnel within different institutions. Participant enrollment continued until thematic saturation was reached. Our interview guide and initial coding were informed by the Consolidated Framework for Implementation Research (CFIR). Interviews were recorded, transcribed, and iteratively coded, and qualitative thematic analysis was used to identify themes and subthemes by consensus. Results: We interviewed 12 medical directors and key informants, including a resident, follow-up nurse, program director, 2 pharmacists, and a physician champion. Some of the primary barriers to EPT were legal liability, lack of a specific implementation process, and the stigma surrounding sexual health. Facilitators of EPT included a clear delineation of task-sharing responsibilities for prescribing EPT, efficient electronic medical record prescribing, and leadership engagement. Many participants acknowledged the ED’s potential role in improving sexual health especially for marginalized populations and expressed a desire to use this practice if it was streamlined and did not affect departmental flow. Conclusions: The non-traditional processes involved in EPT present many challenges for adoption in the ED. Understanding these barriers and facilitators will assist in designing strategies for the implementation of EPT.