- Provide CME/CEU-eligible training to staff and clinicians on evidence-based contraceptive counseling and care that is centered around the patient’s needs and goals
- Implement a pregnancy intention screening question for all patients of reproductive age
- Teach clinicians how to place and remove IUDs and the implant, and provide new learners with access to preceptors. We also provide training on immediate postpartum placement.
- Ensure adequate eligibility screening is conducted
- Increase staff knowledge of all contraceptive methods including mechanism of action, efficacy, risks, side effects and benefits
Improving care across the nation
Upstream partners with health centers to reduce unplanned pregnancy by expanding equitable access to the full range of contraceptive options. By 2024, we will have worked with healthcare practices serving over 1 million women of reproductive age each year.
How we work
In each state, we provide patient-centered training and technical assistance to hospital systems, state and local health departments, Federally Qualified Health Centers (FQHCs), Planned Parenthoods, community agencies and more.
- Provide access to contraceptive protocols, policies and procedures, and consent forms
- Provide customized billing and coding guides for financial and clinical staff
- Integrate pregnancy intention screening questions into care and electronic medical records
- Assist with contraceptive stocking and supplies
- Provide workflow assistance that increases single-visit access to all methods of contraception
- Provide patient education materials in multiple languages for in-center use
- Increase patient knowledge and awareness of contraceptive options and where contraception can be obtained
- Engage patients to provide regular feedback and input
- Ensure that all patients have access to high-quality contraceptive care. Our training curriculum for clinicians includes content on serving LGBTQI+ patients, with special care given to:
- Supporting clinicians in understanding terms related to gender identity and sexual orientation
- Providing case studies throughout the curriculum that include transgender and non-binary patients
- Educating on best practice patient-centered reproductive healthcare for transgender men and non-binary people whose sex assigned at birth was female. This includes how to provide appropriate pelvic exams.
- Conduct regular monitoring and evaluation with each health care partner, including patient surveys and focus groups
- Ensure partners have the tools and skills they need to continue offering patient-centered contraceptive care to all patients once our partnership has concluded
- Evaluate each statewide partnership so that the impact of our work can be understood both in and outside the state
Training for your whole health care team is an essential component of partnering with Upstream. Learn more about our training events and approach.
Upstream is transforming health care so that the full range of contraceptive options are available to all patients wherever they access care. Our results are timely and sustainable—lasting long after our partnership has ended. The chart below shows how providers at partnering health centers increasingly document patients’ reproductive health goals as part of routine screening.
This chart shows the percentage of unduplicated patients aged 15-44 with a Pregnancy Intention Screening Question (PISQ) response documented in a dedicated EHR field over a 12-month period prior to and following Upstream engagement. Because reporting varied slightly by agency, results are not comparable across agencies.
Data were extracted from agency EHRs and analyzed by a third party
In all my years as a medical professional, I’ve never encountered a public health initiative that has made such a dramatic impact on practice change in such a short period of time.”Dr. Karyl Rattay Director, Delaware Division of Public Health