Between 2004 and 2005, the Orange County Health Department (OCHD) in Florida experienced a 45% increase in new early syphilis cases in its jurisdiction, from 136 cases to 195 cases per year. Surveillance data also showed significant increases in early syphilis over the previous four years. If not controlled, early syphilis could have become a larger epidemic, costing the community hundreds of thousands of dollars in health-related costs for early, late, and congenital syphilis cases in addition to potential costs resulting from syphilis-associated human immunodeficiency virus (HIV) transmission.
Grace Duffy worked with the OCHD QI team to involve Disease Intervention Specialists (DIS) to improve the process for blood draws and instituted a tracking and measurement system to ensure that the department met federal standards for random testing of at-risk populations.
Accomplishments of this initiative include the following:
- By the end of the nine-month project, new early syphilis cases leveled off and began to decline. During the same period, syphilis increased in Florida peer counties.
- 100% of DIS conformed to minimum blood draw standards for the last two months.
- Cluster index above CDC standard was achieved for four consecutive quarters and was attributed by team members to better interviewing skills.
- Contact index target was improved but target not met, needing additional action.
Click here to learn more about the Orange County Quality Improvement Project that reduced the spread of syphilis and HIV.