This includes 2% receiving Long-Acting Reversible Contraception (LARC) within three days of giving birth (see Physical HealthChoices Quality Measures).
LARC (IUDs and contraceptive implants) can be offered immediately postpartum (prior to discharge) as a safe, effective postpartum contraception option. Immediate postpartum LARC (IPLARC) also has the potential to reduce unintended and short-interval pregnancy (ACOG Brief)—an objective of Healthy People 2030. Providing access to immediate postpartum contraceptive options, including IPLARC, is also part of the PA PQC’s maternal mortality and maternal OUD Driver Diagrams.
When providers work to make this option available to patients, they often encounter administrative barriers (e.g., reimbursement) and logistical barriers (e.g., stocking IUDs and implants, training providers, configuring IT and billing systems, and providing patient-centered contraceptive counseling). To problem-solve the administrative barriers, the PA PQC policy group is developing recommendations and educational materials for health plans.
To breakthrough the logistical challenges, the PA PQC worked with four PA PQC birth hospitals between May and September 2020 to increase access to IPLARC. Within five months, all four teams created and implemented the structures and processes to routinely counsel, offer, and provide IPLARC. Five additional PA PQC birth hospitals joined the second cohort of providers in October 2020.
To express interest in joining the PA PQC’s IPLARC initiative, please complete the following baseline readiness survey:
https://www.surveymonkey.com/r/W6VPQRJ
Your organization’s PA PQC quality improvement coach will then follow-up with you and your team to identify next steps based on the expectations below.
Click here to view a list of educational materials, toolkits, coding guidelines, and other resources.
PA PQC provider teams in the IPLARC initiative are also leveraging the educational materials and training from ACOG’s Postpartum Contraceptive Access Initiative.
With guidance from your PA PQC quality improvement coach:
- Further expand, develop, and structure your IPLARC multi-disciplinary team with inpatient and outpatient team members
- Organize monthly quality improvement team meetings
- Create and implement a quality improvement plan with your team to develop the supporting structures, processes, team roles, and skills to offer comprehensive contraceptive counseling, including IPLARC (please see the PA PQC IPLARC Driver Diagram for Key Interventions to help focus your quality improvement plan)
- Organize provider trainings on patient-centered contraceptive counseling and LARC insertions/removals
- Complete the IPLARC survey quarterly to track your team’s impact on structural measures
- Report aggregate data for the process measures—eligible individuals who received IPLARC—monthly via the PA PQC Data Portal
- Attend the quarterly PA PQC Learning Sessions, which will include content on IPLARC
- Provide a Quality Improvement Report Out, using the QI Report Out Template, prior to each quarterly PA PQC Learning Session
- Attend the IPLARC-related PA PQC Quality Improvement Collaborative Meetings and Team Talks for peer-to-peer learning