Author: Dr. Anatole S Menon-Johansson
SXT provides services to reduce the spread of sexually transmitted infections (STI) by signposting to local appropriate sexual & reproductive health services, enabling anonymous partner notification (PN) and supporting linkage to care with an integrated booking module. The anonymous PN tool is in clinics with patients who have a new STI diagnosis to inform sexual contacts who are potentially at risk of their need to test and then SXT in turn helps those individuals to find a local clinic and access testing. Up to one third of partners when tested are found to have the infection and many are unaware that they are infected and may unwittingly pass it on.
After the launch of the PN tool in 2016 it was clear that some members of staff were better at engaging with their patients and encouraging them to inform partners than others. The SXT platform can inform partners by SMS or email either in clinic with the healthcare worker or after their visit when the patient is sent a link so that they can do it on their phone in their own time. Even though everybody is anonymous, the SXT platform is able to track how many partners were told and if they were tested. Three times more partners are informed when PN is done in clinic and we wanted to work out what the high performing members of staff were doing differently than their peers. Interviews were performed with the two positive deviants out of a group of ten staff to determine their common tips and tricks and then these were then shared with the group for comment, reflection and then we encouraged all staff to try and emulate their approach.
Finally, we redesigned the software so that the flow, images and text for patients as well as tips and tricks for first time healthcare workers were present to ensure that each stage of the PN tool aligned with the work of the positive deviants. There is still some good work to do to improve the number of partners told and then linked into care to address STI epidemics and to get to zero HIV; however, thanks to the PD approach we have a tool that is supporting clinics to deliver fifty percent more effective PN services with half the staff time.