Oswego County Opportunities in Fulton, NY
Staff at the Centers for Reproductive Health at Oswego County Opportunities, Inc., (OCO) have a long-standing commitment to providing quality, comprehensive services to the women and men of Oswego County using evidence-based strategies. In 2013, OCO committed a multidisciplinary team to participate in the NYS COE’s Learning Collaborative. Although OCO’s performance on Performance Measure #7 (Proportion of eligible female clients leaving with an effective or highly effective form of contraception) a marker of access, was strong when the NYS COE first put out its call for applications for its first Learning Collaborative, OCO program leadership recognized the opportunity for improvement.
As part of the Learning Collaborative, the OCO team began collecting and analyzing clinic data on a regular basis. In response to what it saw, OCO implemented changes that resulted in notable improvements to its practices and systems:
- Clinical staff, support staff, and health educators all received training on evidence-based reproductive health service provision, including evidence-based and best approaches for supporting clients with contraception method selection at initial and all visits, as well as LARC insertion (clinicians).
- To support staff with putting the knowledge and skills learned during trainings into practice, leadership made adjustments to the way care was delivered, “blowing up” its scheduling template, employing a “team-based” model of care delivery, and revising pertinent clinic policies; changes resulted in maximum flexibility for staff to provide clients with same-day access to contraception, including long acting reversible contraceptive (LARC) methods, regardless of the reason for the visit.
- All OCO staff began utilizing consistent messages when providing services to current and new client; messages included that OCO staff would work with each client who does not want to be pregnant to find the right contraceptive method for her, and that the team would partner with clients to remove any financial and logistical barriers to access.
As changes to policies and systems took place, the multidisciplinary Learning Collaborative team, including Title X Project Director and OCO Senior Director of Health & Nutrition Ellen Holst, communicated to all OCO staff that ensuring contraceptive access, including LARC access, to all clients was an organizational priority.
These changes ultimately increased the likelihood that women and teens who want an effective or highly effective form of contraception have access to their method of choice that same-day. In 2011, 72.3% of eligible female clients left with an effective or highly effective method of contraception. This rate increased by 16% to 84.0% in 2014. In 2014, 19.0% of eligible female clients left with a highly effective LARC method.
Ellen Holst remarked that the above changes were not the only outcomes of OCO’s Learning Collaborative participation: “[As a result of the Learning Collaborative], we enhanced our understanding of how performance measurement and management can support achievement of our defined goals…and increased our proficiency to develop organizational strategies for improving performance in other domains.” OCO has an insurance navigation program stationed at its Reproductive Health Center, as well as in community settings. OCO staff and Navigators currently are working together to apply the same quality improvement strategies that were utilized during the Learning Collaborative to improve processes for enrolling clients into health insurance plans through the New York State of Health Marketplace, as well as in the Family Planning Benefit Program (FPBP).