Increasing Contraception Documentation in an Academic Rheumatology Clinic: A Quality Improvement Approach

Objective This quality improvement initiative aimed to increase the rate of provider screening and documentation of contraception use for reproductive‐aged women seen in an academic rheumatology fellows’ clinic to >50% by 24 weeks, with sustained improvement at one year. Methods With a multidisci...

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Main Authors: Caroline H. Siegel, Deanna Jannat‐Khah, Avi L. Mikhaylov, Patrick Fritz, Erika L. Abramson, Lisa R. Sammaritano, Nancy Pan
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:ACR Open Rheumatology
Online Access:https://doi.org/10.1002/acr2.11775
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author Caroline H. Siegel
Deanna Jannat‐Khah
Avi L. Mikhaylov
Patrick Fritz
Erika L. Abramson
Lisa R. Sammaritano
Nancy Pan
author_facet Caroline H. Siegel
Deanna Jannat‐Khah
Avi L. Mikhaylov
Patrick Fritz
Erika L. Abramson
Lisa R. Sammaritano
Nancy Pan
author_sort Caroline H. Siegel
collection DOAJ
description Objective This quality improvement initiative aimed to increase the rate of provider screening and documentation of contraception use for reproductive‐aged women seen in an academic rheumatology fellows’ clinic to >50% by 24 weeks, with sustained improvement at one year. Methods With a multidisciplinary team, we devised and implemented six interventional cycles over 24 weeks informed by key stakeholder survey responses. The primary outcome measure was the percentage of eligible visits with contraception information documented in the structured electronic health record field. The smoking status documentation rate was tracked as a balancing measure, and the percentage of contraception documenters who were non–medical doctor (MD) clinical staff, the target group for the intervention, was tracked as a process measure. Outcome, process, and balancing measures were assessed every two weeks over one year. Results Over 24 weeks, the rate of contraception documentation increased from 11% to 54% (median 30%), and the median smoking status documentation rate was 88% (68%–97% range); the median rate of non‐MD clinical staff documenters was 92% (70%–100% range). Interventions included an introductory educational session with documentation instruction and scripts to guide screening, email reminders from nursing leadership, and interim educational sessions. At one year, the contraception documentation rate was sustained at 50%. Conclusion A multicycle educational intervention led to an increase in the contraception documentation rate from 11% to 54% for reproductive‐aged women seen in an academic rheumatology fellows’ clinic over 24 weeks, with sustained improvement at one year. Future interventions will focus on increasing contraception counseling and referrals for patients in rheumatology clinics who were high risk.
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spelling doaj-art-e8d115561b324109910b362c525d715c2025-02-04T06:21:23ZengWileyACR Open Rheumatology2578-57452025-01-0171n/an/a10.1002/acr2.11775Increasing Contraception Documentation in an Academic Rheumatology Clinic: A Quality Improvement ApproachCaroline H. Siegel0Deanna Jannat‐Khah1Avi L. Mikhaylov2Patrick Fritz3Erika L. Abramson4Lisa R. Sammaritano5Nancy Pan6Hospital for Special Surgery and Weill Cornell Medicine New York New YorkHospital for Special Surgery New York New YorkHospital for Special Surgery New York New YorkHospital for Special Surgery New York New YorkWeill Cornell Medicine New York New YorkHospital for Special Surgery and Weill Cornell Medicine New York New YorkHospital for Special Surgery and Weill Cornell Medicine New York New YorkObjective This quality improvement initiative aimed to increase the rate of provider screening and documentation of contraception use for reproductive‐aged women seen in an academic rheumatology fellows’ clinic to >50% by 24 weeks, with sustained improvement at one year. Methods With a multidisciplinary team, we devised and implemented six interventional cycles over 24 weeks informed by key stakeholder survey responses. The primary outcome measure was the percentage of eligible visits with contraception information documented in the structured electronic health record field. The smoking status documentation rate was tracked as a balancing measure, and the percentage of contraception documenters who were non–medical doctor (MD) clinical staff, the target group for the intervention, was tracked as a process measure. Outcome, process, and balancing measures were assessed every two weeks over one year. Results Over 24 weeks, the rate of contraception documentation increased from 11% to 54% (median 30%), and the median smoking status documentation rate was 88% (68%–97% range); the median rate of non‐MD clinical staff documenters was 92% (70%–100% range). Interventions included an introductory educational session with documentation instruction and scripts to guide screening, email reminders from nursing leadership, and interim educational sessions. At one year, the contraception documentation rate was sustained at 50%. Conclusion A multicycle educational intervention led to an increase in the contraception documentation rate from 11% to 54% for reproductive‐aged women seen in an academic rheumatology fellows’ clinic over 24 weeks, with sustained improvement at one year. Future interventions will focus on increasing contraception counseling and referrals for patients in rheumatology clinics who were high risk.https://doi.org/10.1002/acr2.11775
spellingShingle Caroline H. Siegel
Deanna Jannat‐Khah
Avi L. Mikhaylov
Patrick Fritz
Erika L. Abramson
Lisa R. Sammaritano
Nancy Pan
Increasing Contraception Documentation in an Academic Rheumatology Clinic: A Quality Improvement Approach
ACR Open Rheumatology
title Increasing Contraception Documentation in an Academic Rheumatology Clinic: A Quality Improvement Approach
title_full Increasing Contraception Documentation in an Academic Rheumatology Clinic: A Quality Improvement Approach
title_fullStr Increasing Contraception Documentation in an Academic Rheumatology Clinic: A Quality Improvement Approach
title_full_unstemmed Increasing Contraception Documentation in an Academic Rheumatology Clinic: A Quality Improvement Approach
title_short Increasing Contraception Documentation in an Academic Rheumatology Clinic: A Quality Improvement Approach
title_sort increasing contraception documentation in an academic rheumatology clinic a quality improvement approach
url https://doi.org/10.1002/acr2.11775
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