We have some very exciting news to share with you this month. Since August, we have been working hard to get five of our Upstream Massachusetts partners ready to complete Upstream’s full technical assistance and training program. As of this month, all five health centers have graduated and entered the sustainability stage of program implementation!
Please join me in congratulating our first program graduates in Massachusetts: Community Health Center of Franklin County, Family Health Center of Worcester, Fenway Health, Harvard Street Neighborhood Health Center, and Holyoke Health! ????
We feature three of these health center partners below and look forward to sharing more about our other graduated partners in the coming weeks. Stay tuned for more!
Community Health Center of Franklin County
The Community Health Center of Franklin County (CHCFC) opened the doors of its medical clinic in Turners Falls in 1997 with the mission to provide excellent medical care to all residents of Franklin County, regardless of insurance status or income. Now CHCFC operates 3 clinics to serve the needs of the community.
Upstream has been working with CHCFC since 2019. During our partnership, CHCFC was successful in creating a precepting program in which multiple providers completed IUD and Implant proficiency training, allowing for improved access for patients. Patients are now able to receive these methods during a same-day visit. In addition, new clinical workflows were implemented to enhance screening patients for pregnancy intention, while on-site coaches were trained to support their teams on this new approach. Currently, CHCFC has increased screening from 0% to nearly 75% of eligible patients with a qualifying encounter visit for pregnancy intention.
Before Upstream, contraceptive care and access weren’t a priority or even on our radar, and now it is completely embedded into our practice. We have seen true practice transformation in the care and delivery of contraceptive services.”
— Dr. Allison van der Velden, CEO Community Health Center of Franklin County
Family Health Center of Worcester
Family Health Center was established in 1972 by the city of Worcester and Main South residents who had been receiving care at Worcester City Hospital. Now an FQHC, Family Health Center of Worcester is dedicated to improving the health and well-being of all residents in the Greater Worcester area.
FHCW focuses especially on culturally diverse populations, providing access to affordable, high quality, integrated, comprehensive, and respectful primary health care and social services, regardless of patients’ ability to pay. Upstream has been working with Family Health Center of Worcester since 2020.
FHCW engaged in true practice transformation over the course of Upstream’s program implementation, most notably in clinical operations strategies that were put in place to improve how staff engage in contraceptive conversations. Through a combination of easily accessible educational resources and staff training to improve contraceptive competency, access to reproductive care became embedded throughout primary care. Over the course of the partnership, FHCW was able to bring wait times for IUD and Implant insertion down from 2 months to under 2 weeks.
Upstream has brought energy and commitment to serve this population in a very meaningful way, giving people this choice… By proactively engaging in this [contraceptive care] conversation, the lives of the patients you are having this conversation with end up following a very different trajectory.”
— Louis Brady, President & CEO of Family Health Center of Worcester
Fenway Health
Founded in 1971 as part of the free clinic movement by students who believed that “health care should be a right, not a privilege,” Fenway Health started as a small drop-in clinic providing free blood pressure checks and sexually transmitted diseases (STD) screenings.
Today, Fenway is a freestanding, Federally Qualified Health Center (FQHC) with a staff of more than 600 and a patient population of more than 33,000. Fenway’s mission is to enhance the wellbeing of the LGBTQIA+ community and all people in Boston’s Fenway neighborhood and beyond through access to the highest quality healthcare, education, research and advocacy. Upstream started working with Fenway Health in 2020.
Integrating gender-affirming care into patient care is crucial at Fenway. To ensure gender-affirming contraceptive care at the health center, Upstream’s Quality Improvement team partnered with Fenway’s contraceptive care champions to adapt the Pregnancy Intention Screening Question (PISQ) language to ensure it was inclusive of all genders.
The solution was to choose a PISQ that focuses on Parenting intention — “Would you like to become a parent in the next year?” This new PISQ opened the door for further discussions about diverse healthcare needs.
“Upstream’s focus on an anatomy-based approach to contraceptive care has allowed this program to seamlessly incorporate into Fenway’s reproductive health management and improve our care…basing questions and care on an individual’s anatomy, reproductive potential, and goals provides a clearer path to communication, education, and understanding of a patient’s needs and desires.”
— Julie Thompson, PA‑C, Medical Director of Trans Health at Fenway
