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Taking Contraception UtilizationRates to the Next Level:
Strategies for Realizing the Goalsof the Title X Program
Strategies for Realizing the Goalsof the Title X Program
NYS Center of Excellence for Family Planningand Reproductive Health Services
Thursday, November 15, 2012
Welcome
IntroductionsElizabeth Jones
Director, NYS Center of Excellence for Family Planningand Reproductive Health Services
CAICAI
PresenterDawn Middleton
Director, Quality ImprovementCAI
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NYS COE PerformanceManagement Initiative
•A partnership with the New York State Departmentof Health (NYS DOH) to support efforts to monitorand improve outcomes in communities served byNYS DOH-funded family planning providersNYS DOH-funded family planning providers
•The Performance Management Initiative aims toenhance family planning providers’ ability to collect and use data to measure and improveperformance
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Webinar Objectives
•Review the objectives of the New York State Centerof Excellence for Family Planning and ReproductiveHealth Services’ (NYS COE) Performance Management InitiativeManagement Initiative
•Consider core concepts associated with usingperformance measurement data to improveprogram outcomes
•Review the objectives of and pre-work assignmentsfor participation in upcoming face-to-face trainings
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Where to Start?
•Contraceptive Coverage - Measure #7: Percentageof unduplicated female clients leaving with aneffective method of contraception–Primary aim of the Title X program is to reduce
unintended pregnancyunintended pregnancy–Accomplished through ensuring access to hormonal
contraception and IUDs
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How are we doing?
•Performance Measures–Facilitate assessment of progress toward theTitle X program’s aims
•Continuous Quality Improvement–Opportunity to improve every process on every
occasion
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Contraceptive Coverage
Measure:Percentage ofunduplicatedfemale clients
2011 NYS Average 2011 NYS Range
Count % % Min % Max
Total 180,214 55.2% 14.6% 81.4%
Hispanic 45,851 53.6% 21.6% 86.4%
White Non-Hispanic 79,177 65.0% 7.3% 91.7%female clientsleaving with aneffective methodof contraception
White Non-Hispanic 79,177 65.0% 7.3% 91.7%
Black Non-Hispanic 36,475 45.6% 9.5% 90.0%
Less than 15 years 1,801 50.6% 1.9% 100.0%
15-17 years 16,104 58.3% 8.6% 91.3%
18-19 years 19,542 56.4% 17.2% 85.4%
20-24 years 54,340 57.2% 11.6% 85.5%
25-29 years 42,180 57.9% 8.3% 84.0%
30 years and over 46,247 49.7% 11.7% 82.9%
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“Every System is Designed Perfectly to Get the Results it Gets”
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~ W. Edwards Deming,“Father of Improvement”
Taking Contraception UtilizationRates to the Next Level:
Strategies for Realizing the GoalsStrategies for Realizing the Goalsof the Title X Program
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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 andutilization of contraceptionutilization of contraception
2. Develop an organizational strategy for improvingrates of contraceptive utilization
3. Develop a system for measuring and monitoringprogress towards improving rates of contraceptiveutilization
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Contraceptive Access
System-level Individual and Community-level
Steps in the Delivery of Care(i.e. providing access tocontraception at every visit)
Awareness and Knowledge
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contraception at every visit)
Contraceptive Supplies Ambivalence
Policies and Protocols Partner Influence
Staffing Utilization and Mix Community Norms
Hours and Days of Operation Social Determinants
Contraceptive Access:Systems-level
Steps in the Delivery of Care
Contraceptive SuppliesBudget
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Steps in the Delivery of Care
Staff Utilization
Clinical Policiesand Protocols
Pre-Work AssignmentsExamining how:
•Steps in Delivery of Care•Staff Utilization•Staff Utilization•Supplies•Policies and Procedures
Shape how contraception is made available tofemale clients
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Summary of Pre-work AssignmentsAREA TOOL
Steps in Delivery of CareVISIT FLOW WORKSHEET 1Staff Utilization
Staffing MixSuppliesSupplies
WORKSHEETS 2A & 2BBudgetTraining ParticipantsHealth CenterPolicies and Procedures WORKSHEET 3Site Specific ContraceptiveCoverage WORKSHEET 4
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Focus Pre-work Assignments onOne Health Center
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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 week30 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
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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–Identify when access to contraception is offered by visit
type and during what step in the process of delivery ofcare
•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
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Worksheet #1
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Worksheet #2
•Purpose:–Review contraceptive method choices available on the
health center formulary–Review the proportion of the total budget allocated to
contraceptive suppliescontraceptive supplies–Identify training participants–Select a health center at which to implement strategies
to improve contraceptive utilization developed at theface-to-face training
•Tips for Completion:–Include your entire Title X budget
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Worksheet #2A
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Worksheet #2A
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Worksheet #2A
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Worksheet #2B
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Worksheet #2B
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Worksheet #3
•Purpose:–Examine clinical guidelines
•Tips for Completion:–Involve your Medical Director, Clinician, Clinic
Administrator or Manager
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Worksheet #3
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Worksheet #4
•Purpose:–Establish a baseline contraceptive coverage rate–a
place from which to monitor and track improvement
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Worksheet #4
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Data, Information & Knowledge
Data InformationKnowledge
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Data Information
Participants:Agency Leaders who Should Plan to Attend
Face-to-face TrainingsFace-to-face Trainings
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Participants
•Each agency should assemble a multi-disciplinaryteam that includes staff persons with sufficientknowledge as to be able to inform thedevelopment of strategies to improvedevelopment of strategies to improvecontraceptive uptake, specifically knowledge of:–Health center processes or steps in delivery of care–Staff resources available–Opportunities for “task shifting”–Medical policies and protocols
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Participants
•Training participant team members should havesufficient power, authority, and influence toimplement strategies to improve contraceptiveutilization that are developed at the trainingutilization that are developed at the training
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Participants
•Teams can be as large as 5 participants and assmall as 2 participants and may include:–Medical Director or Clinician–Organizational/Health Center Administrator/ManagerOrganizational/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
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Summary of Assignments
•Select Training Team Participants•Select Health Center•Complete Worksheets 1-4•Return to CAI by November 28, 2012•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
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Training Registration & Logistics
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Training Dates & Locations
DATE CITY LOCATION
Thursday, Dec. 6 Syracuse, NY Genesee Grande Hotel1060 East Genesee Street
Friday, Dec. 7 Albany, NY CAI Albany2 Winners Circle2 Winners Circle
Thursday, Dec. 13 New York City CAI New York City505 Eighth Avenue, 20th Floor
Friday, Dec. 14 New York City CAI New York City505 Eighth Avenue, 20th Floor
Thursday, Jan. 10 Fishkill, NY Hyatt House Fishkill100 Westgate Business Drive
Tuesday, Jan. 15 Cheektowaga,NY
Holiday Inn Buffalo Airport4600 Genesee Street
Registration
•Registration forms will be re-circulated followingthis Webinar, along with pre-work assignmentworksheet
•Please submit one registration form per agency if•Please submit one registration form per agency ifyou have not already registered
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Questions?
Colleen ForemanDirector of the Community Based Health Unit,Bureau of Maternal and Child Health, NYS DOH
Dawn MiddletonDawn MiddletonDirector of Quality Improvement , CAI
Elizabeth JonesDirector of the New York State Center of Excellence
for Family Planning and Reproductive Health Services, CAI
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