Addressing Sexually Transmitted Disease Management Through Practitioner Education on Florida Reporting Requirements in Manatee County: A Quality Improvement Initiative

Abstract

Introduction: Successful public health interventions depend on accurate disease surveillance, which can be hindered by inconsistent reporting of confirmed cases of disease by practitioners. This quality improvement project aimed to develop an intervention that will lead to an increase in the number of practitioner disease reporting forms (PDRFs) submissions to the Florida Department of Health in Manatee County (DOH-Manatee) for all sexually transmitted disease and infection (STD/STI)-positive laboratory results. Methods: Following the Standards for Quality Improvement Reporting Excellence (SQUIRE) 2.0 Guidelines, the Plan-Do-Study-Act methodology was utilized and led to the use of a mixed-methods approach. The quantitative analysis included comparing the number of positive STD/STI tests to the number of submitted PDRFs. The qualitative data collection included surveys with Disease Intervention Specialists (DIS) at the DOH-Manatee to identify successful practices, challenges with practitioners, and factors preventing follow-up. Interventions included creation of an email and letter containing Florida Statutes reporting guidelines, standardized PDRFs, and clear submission instructions. The intervention is on hold, pending approval of the design and outreach plan by DOH-Manatee and the Florida Department of Health. Results: Of the three DOH-Manatee DIS, two responded. They reported barriers to form submission, including limited practitioner education on reporting guidelines, insufficient patient contact information on laboratory reports, and lack of practitioners’ knowledge of DIS jurisdiction. Notably, both survey responders indicated uncertainty about tracking processes for positive laboratory results and PDRFs. Interventions that have been successful in the past included DIS members visiting practitioner offices and speaking with them directly. Per DOH-Manatee DIS, Manatee County had 196 positive tests, but only 45 PDRFs (23%) were faxed in July 2025. Discussion: Underreporting of PDRFs impacts efforts to control rates of STDs/STIs by delaying patient treatment and follow-up services. Limitations included restricted access to DOH-Manatee data, switching from focus group to survey methodology, and leadership turnover affecting internal operations. Conclusion: Stronger practitioner education and collaboration between healthcare systems and public health should enhance reporting compliance and reduce ongoing transmission. Planned interventions include targeted practitioner education on Florida Statutes reporting requirements and clarification of practitioner roles in disease transmission prevention. These outreach efforts will be continued internally within the quality improvement (QI) division of the DOH-Manatee.