Unfamiliarity, Increased Workload
EPT
STIS
Frequently mentioned inner-setting characteristics included knowledge of the basic concept of EPT and time constraints in using it. Almost all participants were able to accurately or at least partially define EPT. Although most participants were familiar with the concept, only about half knew how to order EPT at the study site.I didn’t know the program existed and did not know how to use the order set or that it was available. (Participant 8)While the majority were supportive of having EPT available as an option, the extra work involved in education was cited by several participants as a barrier. They stated that some patients may not understand STIs and thus need extra counseling. Especially in a busy ED, the extra time involved in bridging these knowledge gaps was undesirable.[A barrier is] explaining to the patient how to explain to partner, which can be challenging…not insurmountable. (Participant 19)Culture at the study site was also frequently cited as a barrier. These clinicians stated that EPT is not a common practice and it was challenging to remember to use it. Further, several participants viewed EPT as less impactful in EDs with a lower volume of STI visits.It feels strange to write a prescription without a name on it. Giving it to someone you’ve never met or interacted with feels strange; it’s a change in practice. (Participant 1)Participants also mentioned ways to change this culture. Two clinicians stated that incorporating EPT into the standard of practice is the best long-term solution for clinicians to order EPT consistently.I think everyone just needs to do it once, and then it will be a part of our practice. The volume of us seeing an exposure needs to grow and then just knowing to do it from now on. (Participant 6)