Leading the way in pediatric sexual health screenings: evaluating pediatric emergency department workflows for the integration of STI screening tools
IntroductionEmergency department (ED) encounters offer strategic opportunities for sexually transmitted infection (STI) screening, prevention, and treatment for adolescents at risk for STIs who may not otherwise have access to routine screening. This study determined optimal ED implementation of the...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2025-03-01
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| Series: | Frontiers in Health Services |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/frhs.2025.1493318/full |
| _version_ | 1826554189291978752 |
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| author | Laura Schubel Deanna-Nicole Busog Azade Tabaie Monika Lemke Danielle Foltz Gia Badolato Natasha Ajay Kaushal Monika K. Goyal Monika K. Goyal Monika K. Goyal Kristen Miller Kristen Miller |
| author_facet | Laura Schubel Deanna-Nicole Busog Azade Tabaie Monika Lemke Danielle Foltz Gia Badolato Natasha Ajay Kaushal Monika K. Goyal Monika K. Goyal Monika K. Goyal Kristen Miller Kristen Miller |
| author_sort | Laura Schubel |
| collection | DOAJ |
| description | IntroductionEmergency department (ED) encounters offer strategic opportunities for sexually transmitted infection (STI) screening, prevention, and treatment for adolescents at risk for STIs who may not otherwise have access to routine screening. This study determined optimal ED implementation of the Teen Health Screen (THS), a validated, tablet-based, patient-reported, sexual risk assessment, and evaluated its implementation feasibility under variable workflows and high-stress tasks.MethodsWorkflow analysis included semi-structured interviews with patients, caregivers, and clinical staff members and clinical observations to understand patient and clinical workflow. The study was conducted in two urban pediatric EDs over six weeks. Participants included patients, parents/caregivers, registration staff, nurses, social workers, child life specialists, providers, and health IT experts.ResultsThe primary study outcome was development of a general model of ED workflow and patient-clinician engagement, focusing on patient flow, clinical tasks, people, and technologies involved. Workflow analyses identified key opportunities for THS deployment during the nurse assessment process, which aligns with other existing screening activities and offers privacy. This approach addresses potential barriers to integration such as privacy concerns, language and literacy barriers, the sensitivity of discussing sexual history, comfort with technology, tablet accessibility and security, and internet availability.DiscussionWorkflow analysis provided valuable insights to the perceptions, thoughts, and practicality of implementing the THS in the ED. Interviews revealed general acceptance of the new process but highlighted logistical challenges, particularly with staffing and patient surge. Implementing the THS in ED settings appears feasible, with important opportunities identified for integration to improve patient safety, including staffing and workflow optimization. |
| first_indexed | 2025-03-14T07:36:57Z |
| format | Article |
| id | doaj.art-b78a215ccb2544e49b51de2028c36d00 |
| institution | Directory Open Access Journal |
| issn | 2813-0146 |
| language | English |
| last_indexed | 2025-03-14T07:36:57Z |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Health Services |
| spelling | doaj.art-b78a215ccb2544e49b51de2028c36d002025-03-03T07:07:23ZengFrontiers Media S.A.Frontiers in Health Services2813-01462025-03-01510.3389/frhs.2025.14933181493318Leading the way in pediatric sexual health screenings: evaluating pediatric emergency department workflows for the integration of STI screening toolsLaura Schubel0Deanna-Nicole Busog1Azade Tabaie2Monika Lemke3Danielle Foltz4Gia Badolato5Natasha Ajay Kaushal6Monika K. Goyal7Monika K. Goyal8Monika K. Goyal9Kristen Miller10Kristen Miller11National Center for Human Factors in Healthcare, MedStar Health Research Institute, Washington, DC, United StatesNational Center for Human Factors in Healthcare, MedStar Health Research Institute, Washington, DC, United StatesCenter for Biostatistics Informatics and Data Science, MedStar Health Research Institute, Washington, DC, United StatesChildren’s National Hospital, Washington, DC, United StatesChildren’s National Hospital, Washington, DC, United StatesCenter for Translational Research, Children’s National Hospital, Washington, DC, United StatesCenter for Translational Research, Children’s National Hospital, Washington, DC, United StatesCenter for Translational Research, Children’s National Hospital, Washington, DC, United StatesEmergency Medicine and Trauma Services, Children’s National Hospital, Washington, DC, United StatesDepartment of Pediatrics, George Washington University, Washington, DC, United StatesNational Center for Human Factors in Healthcare, MedStar Health Research Institute, Washington, DC, United StatesSchool of Medicine, Georgetown University, Washington, DC, United StatesIntroductionEmergency department (ED) encounters offer strategic opportunities for sexually transmitted infection (STI) screening, prevention, and treatment for adolescents at risk for STIs who may not otherwise have access to routine screening. This study determined optimal ED implementation of the Teen Health Screen (THS), a validated, tablet-based, patient-reported, sexual risk assessment, and evaluated its implementation feasibility under variable workflows and high-stress tasks.MethodsWorkflow analysis included semi-structured interviews with patients, caregivers, and clinical staff members and clinical observations to understand patient and clinical workflow. The study was conducted in two urban pediatric EDs over six weeks. Participants included patients, parents/caregivers, registration staff, nurses, social workers, child life specialists, providers, and health IT experts.ResultsThe primary study outcome was development of a general model of ED workflow and patient-clinician engagement, focusing on patient flow, clinical tasks, people, and technologies involved. Workflow analyses identified key opportunities for THS deployment during the nurse assessment process, which aligns with other existing screening activities and offers privacy. This approach addresses potential barriers to integration such as privacy concerns, language and literacy barriers, the sensitivity of discussing sexual history, comfort with technology, tablet accessibility and security, and internet availability.DiscussionWorkflow analysis provided valuable insights to the perceptions, thoughts, and practicality of implementing the THS in the ED. Interviews revealed general acceptance of the new process but highlighted logistical challenges, particularly with staffing and patient surge. Implementing the THS in ED settings appears feasible, with important opportunities identified for integration to improve patient safety, including staffing and workflow optimization.https://www.frontiersin.org/articles/10.3389/frhs.2025.1493318/fullemergency medicinescreeningsexual healthpediatricsadolescentsworkflow analysis |
| spellingShingle | Laura Schubel Deanna-Nicole Busog Azade Tabaie Monika Lemke Danielle Foltz Gia Badolato Natasha Ajay Kaushal Monika K. Goyal Monika K. Goyal Monika K. Goyal Kristen Miller Kristen Miller Leading the way in pediatric sexual health screenings: evaluating pediatric emergency department workflows for the integration of STI screening tools Frontiers in Health Services emergency medicine screening sexual health pediatrics adolescents workflow analysis |
| title | Leading the way in pediatric sexual health screenings: evaluating pediatric emergency department workflows for the integration of STI screening tools |
| title_full | Leading the way in pediatric sexual health screenings: evaluating pediatric emergency department workflows for the integration of STI screening tools |
| title_fullStr | Leading the way in pediatric sexual health screenings: evaluating pediatric emergency department workflows for the integration of STI screening tools |
| title_full_unstemmed | Leading the way in pediatric sexual health screenings: evaluating pediatric emergency department workflows for the integration of STI screening tools |
| title_short | Leading the way in pediatric sexual health screenings: evaluating pediatric emergency department workflows for the integration of STI screening tools |
| title_sort | leading the way in pediatric sexual health screenings evaluating pediatric emergency department workflows for the integration of sti screening tools |
| topic | emergency medicine screening sexual health pediatrics adolescents workflow analysis |
| url | https://www.frontiersin.org/articles/10.3389/frhs.2025.1493318/full |
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