Upstream Washington State Plan Overview May 2018 Who We Are - - PowerPoint PPT Presentation

Upstream Washington

State Plan Overview

May 2018

Upstream is a nonprofit organization that helps health centers across the country eliminate barriers that prevent women from obtaining the full range of contraceptive methods so that all women are empowered to become pregnant only when they want to.

Who We Are

And, up to 48% of all pregnancies are estimated to be unplanned.**

35%

• f all births in

Washington are unplanned*

*Source: Washington State Department of Health, PRAMS (2014) **Source: Guttmacher Institute, based on latest available data (2010)

Unplanned Pregnancy in Washington

Unplanned pregnancy can cause women to drop out

• f school, disrupt their careers, and lead to poorer birth
• utcomes for children, all of which limit economic

and educational opportunity.

41%

Nearly half of these pregnancies occur to women using contraception. Unplanned Pregnancy’s Role

https://www.guttmacher.org/fact-sheet/contraceptive-use-united-states

Goals for better Contraceptive Access

Every Woman Any Method A Single Visit

4.6% 5.4% 6.2% 11.5% 15.4%

2012 2013 2014 2015 2016

Source: Title X data: % of all women aged 15-44, excluding those pregnant or seeking pregnancy

Our Results: Delaware Title X Sites

6

Upstream intervention start (late 2014)

End Method Rates, 2012-2016

1%

Mostly clinic staff chose

99%

• f patients made their own

choices about birth control

• r used shared-decision

making with their providers Our Results: Delaware Patient Survey Who chose your birth control method today?

Our Results: Unintended Pregnancy Rates

Simulated unintended pregnancy rates among Title X family planning clients ages 20-29 in Delaware and the United States

Source: ChildTrends

Pregnancies per 1,000 family planning clients

After the first two years of Upstream's partnership with the state of Delaware, there was an estimated 15% decrease in unplanned pregnancies among Title X patients.

+

Specialized Training Technical Interventions

Sustainable solutions to the five biggest barriers to contraceptive access:

Lack of trained providers Screening for pregnancy intention Issues billing, coding and stocking LARCs Clinic workflow Consumer awareness

=

Consumer Marketing

+

Our Approach

Training for Providers

• Barriers
• LARC Background & Education
• CDC Family Planning Guidelines
• Patient Education & Counseling
• IUD Placement & Practicum
• Complications & Management

Training for Support Staff

• Barriers
• Patient-Centered Counseling Skills
• Contraceptive Information
• Addressing Contraception Myths & Facts
• Putting new skills to practice:

Contraceptive Counseling

• Implementation Coaches

Pediatric Work

Basics

• PISQ
• Focus on creating space to discuss reproductive health
• Confidentiality
• Insurance
• Take Charge program
• Contraception options
• Rumor mill
• Training has focus on contraceptive myths
• Patient education information

Referral Network

Basics

• Upstream trains site referral networks
• Updated Counseling and contraceptive education materials
• Based on site’s existing referral partners
• Ex: family planning agency and in-home care
• Updated counseling & patient education materials
• Translated into many languages

Be Your Own Baby

• Targeted marketing campaign to drive business

back into clinics

• Youtube Video

https://www.youtube.com/watch?v=uLtUWLXhx4M

• Website: www.beyourownbaby.org
• Information on contraceptive options
• List of agencies who completed Upstream

engagement & offer all methods

• Instagram
• Facebook
• Transportation: Uber & public transit

Quality Improvement Timeline

IMPLEMENTATION PHASE INITIAL CONTACT ADMINISTRATIVE PHASE

QI work begins, including regular meetings between site-assigned Upstream Quality Improvement Officer (QIO) & site champion Financial technical assistance Consulting occurs before or after on- site training; QI continues On-site training for all staff

• ccurs

Practice sessions with pelvic simulator during

• n-site training or on

different day; clinician precepting begins Upstream QIO continues to provide QI + TA; Implementation Coach provides

• n-site support

focused on model adoption Clinician precepting and mentoring is supported and completed Ongoing QI, TA and implementation support provided MEET SUPPORT GAIN LEARN APPLY LAUNCH MAINTAIN

Site signs Memorandum

• f Understanding

& Equipment Use Agreement Needs assessment with Quality Improvement (QI) team Site signs up for Azara platform and Upstream collects baseline data for pre/post comparisons Dates set for training & Quality Improvement kick-off Initial site recruitment meeting with Upstream representative + site leadership

In Washington we are seeking and preparing partners focused on meeting goals and achieving impact.

540K

Women of reproductive age (WRA) reached by heath centers served when project is complete Public and private health sites receive training and technical assistance

300

Years of training and technical assistance delivery, starting in 2019

5

Participating agencies; including FQHCs, Tribal and IHS providers, rural health centers, and private providers serving a high percentage of Medicaid patients

40

Washington: Our Planned Scope

Questions?

Breanne Laughery

Director of Partnerships, Upstream Washington (206) 915-1257 blaughery@upstream.org