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 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
  • 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

Our training

Training for your whole health care team is an essential component of partnering with Upstream. Learn more about our training events and approach.

Learn more

Where we work

We provide comprehensive training and technical assistance to health centers across an entire state at once to ensure all patients have access to the birth control method of their choice.

Our partnership values

We meet every organization where they are, working together to improve contraceptive care. We tailor aspects of our model to our partners’ needs, making sure that our training and technical assistance is seamlessly integrated into their organizational processes and culture.

We prioritize the patient experience

We meet every partner where they are

We give our partners the resources they need

Our interventions are timely and efficient

We create sustainable results

Our results

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.

PISQ adoption chart

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  

Partner with us

Upstream is currently recruiting healthcare partners across Washington, Massachusetts, North Carolina, and Rhode Island. Contact us to learn more about partnering in these states or to learn about future engagements.

Contact us