Taking Contraception Utilization Rates to the Next Level: Strategies for Realizing the Goals of the Title X Program

Transcription

1 Taking Contraception Utilization Rates to the Next Level: Strategies for Realizing the Goals of the Title X Program NYS Center of Excellence for Family Planning and Reproductive Health Services Thursday, November 15, 2012

2 Welcome Introductions Elizabeth Jones Director, NYS Center of Excellence for Family Planning and Reproductive Health Services CAI Presenter Dawn Middleton Director, Quality Improvement CAI 2

3 NYS COE Performance Management Initiative A partnership with the New York State Department of Health (NYS DOH) to support efforts to monitor and improve outcomes in communities served by NYS DOH-funded family planning providers The Performance Management Initiative aims to enhance family planning providers ability to collect and use data to measure and improve performance 3

4 Webinar Objectives Review the objectives of the New York State Center of Excellence for Family Planning and Reproductive Health Services (NYS COE) Performance Management Initiative Consider core concepts associated with using performance measurement data to improve program outcomes Review the objectives of and pre-work assignments for participation in upcoming face-to-face trainings 4

5 Where to Start? Contraceptive Coverage - Measure #7: Percentage of unduplicated female clients leaving with an effective method of contraception Primary aim of the Title X program is to reduce unintended pregnancy Accomplished through ensuring access to hormonal contraception and IUDs 5

6 How are we doing? Performance Measures Facilitate assessment of progress toward the Title X program s aims Continuous Quality Improvement Opportunity to improve every process on every occasion 6

7 Contraceptive Coverage Measure: Percentage of unduplicated female clients leaving with an effective method of contraception 2011 NYS Average 2011 NYS Range Count % % Min % Max Total 180, % 14.6% 81.4% Hispanic 45, % 21.6% 86.4% White Non-Hispanic 79, % 7.3% 91.7% Black Non-Hispanic 36, % 9.5% 90.0% Less than 15 years 1, % 1.9% 100.0% years 16, % 8.6% 91.3% years 19, % 17.2% 85.4% years 54, % 11.6% 85.5% years 42, % 8.3% 84.0% 30 years and over 46, % 11.7% 82.9% 7

8 Every System is Designed Perfectly to Get the Results it Gets ~ W. Edwards Deming, Father of Improvement 8

9 Taking Contraception Utilization Rates to the Next Level: Strategies for Realizing the Goals of the Title X Program 9

10 Training Objectives As a result of this training, participants will be able to: 1. Conduct an assessment of agency capacity and current practices related to access to and utilization of contraception 2. Develop an organizational strategy for improving rates of contraceptive utilization 3. Develop a system for measuring and monitoring progress towards improving rates of contraceptive utilization 10

11 Contraceptive Access System-level Individual and Community-level Steps in the Delivery of Care (i.e. providing access to contraception at every visit) Contraceptive Supplies Policies and Protocols Staffing Utilization and Mix Hours and Days of Operation Awareness and Knowledge Ambivalence Partner Influence Community Norms Social Determinants 11

12 Contraceptive Access: Systems-level Steps in the Delivery of Care Staff Utilization Contraceptive Supplies Budget Clinical Policies and Protocols 12

13 Pre-Work Assignments Examining how: Steps in Delivery of Care Staff Utilization Supplies Policies and Procedures Shape how contraception is made available to female clients 13

14 Summary of Pre-work Assignments AREA Steps in Delivery of Care Staff Utilization Staffing Mix Supplies Budget Training Participants Health Center TOOL VISIT FLOW WORKSHEET 1 WORKSHEETS 2A & 2B Policies and Procedures WORKSHEET 3 Site Specific Contraceptive Coverage 14 WORKSHEET 4

15 Focus Pre-work Assignments on One Health Center 15

16 Site Selection Criteria If Possible: Overall contraceptive coverage rate is less than 50% Number of visits made by female clients under age 30 is greater than or equal to 100 per week Site is stable Staff persons have a high interest in innovation Progress toward improvement will be able to be monitored 16

17 Worksheet #1 Purpose: Examine steps in the delivery of care by visit type Examine roles and responsibilities of staff within each step of the process Identify when access to contraception is offered by visit type and during what step in the process of delivery of care Tips for Completion: Draw on a multidisciplinary team (during a staff meeting) Include Visit Types: Emergency contraception, Pregnancy-test only, STI testing only, HIV testing only 17

18 Worksheet #1 18

19 Worksheet #2 Purpose: Review contraceptive method choices available on the health center formulary Review the proportion of the total budget allocated to contraceptive supplies Identify training participants Select a health center at which to implement strategies to improve contraceptive utilization developed at the face-to-face training Tips for Completion: Include your entire Title X budget 19

20 Worksheet #2A 20

21 Worksheet #2A 21

22 Worksheet #2A 22

23 Worksheet #2B 23

24 Worksheet #2B 24

25 Worksheet #3 Purpose: Examine clinical guidelines Tips for Completion: Involve your Medical Director, Clinician, Clinic Administrator or Manager 25

26 Worksheet #3 26

27 Worksheet #4 Purpose: Establish a baseline contraceptive coverage rate a place from which to monitor and track improvement 27

28 Worksheet #4 28

29 Data, Information & Knowledge Data Information Knowledge 29

30 Participants: Agency Leaders who Should Plan to Attend Face-to-face Trainings 30

31 Participants Each agency should assemble a multi-disciplinary team that includes staff persons with sufficient knowledge as to be able to inform the development of strategies to improve contraceptive uptake, specifically knowledge of: Health center processes or steps in delivery of care Staff resources available Opportunities for task shifting Medical policies and protocols 31

32 Participants Training participant team members should have sufficient power, authority, and influence to implement strategies to improve contraceptive utilization that are developed at the training 32

33 Participants Teams can be as large as 5 participants and as small as 2 participants and may include: Medical Director or Clinician Organizational/Health Center Administrator/Manager Quality Improvement Director/Coordinator Fiscal Director or Chief Financial Officer Front-line Staff Champion Pilot Health Center Clinic Manager or Champion 33

34 Summary of Assignments Select Training Team Participants Select Health Center Complete Worksheets 1-4 Return to CAI by November 28, 2012 Send to the attention of Elizabeth Jones Request support and technical assistance at any time Prior to attending the training, review and discuss pre-work assignments with training participants 34

35 Training Registration & Logistics 35

36 Training Dates & Locations DATE CITY LOCATION Thursday, Dec. 6 Syracuse, NY Genesee Grande Hotel 1060 East Genesee Street Friday, Dec. 7 Albany, NY CAI Albany 2 Winners Circle Thursday, Dec. 13 New York City CAI New York City 505 Eighth Avenue, 20 th Floor Friday, Dec. 14 New York City CAI New York City 505 Eighth Avenue, 20 th Floor Thursday, Jan. 10 Fishkill, NY Hyatt House Fishkill 100 Westgate Business Drive Tuesday, Jan. 15 Cheektowaga, NY Holiday Inn Buffalo Airport 4600 Genesee Street

37 Registration Registration forms will be re-circulated following this Webinar, along with pre-work assignment worksheet Please submit one registration form per agency if you have not already registered 37

38 Questions? Colleen Foreman Director of the Community Based Health Unit, Bureau of Maternal and Child Health, NYS DOH Dawn Middleton Director of Quality Improvement, CAI Elizabeth Jones Director of the New York State Center of Excellence for Family Planning and Reproductive Health Services, CAI 38

39 Thank You! For additional information, please contact: Elizabeth Jones , ext. 228