RT Journal Article
SR Electronic
T1 Using performance measures in tandem to improve quality in contraceptive care
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 6264
DO 10.1370/afm.22.s1.6264
VO 22
IS Supplement 1
A1 Dehlendorf, Christine
A1 Gibson, Lindsey
YR 2024
UL http://www.annfammed.org/content/22/Supplement_1/6264.abstract
AB Context: Community health centers (CHCs) provide critical safety-net health care for millions of underserved patients in the U.S., including one-third of low-income women of reproductive age. Ensuring access to quality contraceptive care at CHCs is crucial to achieving reproductive health equity.Objective: To assess the impact of a year-long quality improvement learning collaborative (QILC) on contraceptive care at CHCs, using two complementary performance measures. Study Design and Analysis, Setting or Dataset: Pre-post analysis of two contraceptive care quality measures. The Person-Centered Contraceptive Counseling (PCCC) measure evaluates the quality of contraceptive counseling. The Self-Identified Need for Contraception-based electronic clinical quality measures (SINC-based eCQMs) measure if patients who self-identify their interest in contraception receive a method.Population Studied: Ten CHCs, representing 30 clinical sites across eight states.Intervention/Instrument: Participants completed a nine-month quality improvement learning collaborative, focused on building person-centered contraceptive care practices. The QILC included one-on-one technical assistance calls, access to additional training and tools, and monthly learning sessions on integral topics, such as reproductive health equity, racial justice and person-centered contraceptive counseling. CHCs collected 50 PCCC surveys at baseline and received a detailed report of their scores.Participants utilized their PCCC reports to develop quality improvement plans and shared their progress throughout the QILC to facilitate peer learning.Outcome Measures: Change in PCCC and SINC-based eCQM scores.Results: Baseline PCCC scores ranged from 30% to 94%. At endline, six of ten CHCs improved their PCCC score (Δ 2% - 24%) and four of those surpassed the 80% benchmark for high-quality care. At baseline, few patients were screened with SINC (range: <1% - 36%). Median increase in percentage of eligible patients screened was 10% (range: <1% - 46%) across CHCs. CHCs observed a modest increase in eCQMs for use of most or moderately effective contraceptive methods (mdn change: 2%; range: [<1% - 9%]).Conclusions: Participation in a structured, performance measures-driven QILC increased person-centered screening for contraceptive need and improved contraceptive counseling. This project can serve as a model for future quality improvement initiatives using performance measures to facilitate change