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Resources for this component can be found in the Strategy and Resource Guide located in the menu on the upper right-hand side of the page
in this document, refers to those who are vulnerable, experience unequal access to health care and/or who experience the burden or risk of health disparities due in part to race, ethnicity, culture, socioeconomic status, geography, gender, age, disability status, risk status related to sex and gender, and other factors.
umbrella term for people whose gender identity and/or gender expression differs from what is typically associated with the sex they were assigned at birth. (Note: Transgender is correctly used as an adjective, not a noun, thus “transgender people” is appropriate but “transgenders” is often viewed as disrespectful.)
term used by some individuals who identify as neither entirely male nor entirely female. Also termed gender-queer.
The impact of culture on access to and quality of care is particularly important to address in health care. As Oregon’s population of diverse racial and ethnic communities and linguistic groups continues to increase, patients and providers bring with them individual, learned patterns of language and culture. All of these patterns affect the health care experience.
refers to individuals who are unable to communicate effectively in English because their primary language is not English.
defined by the HHS National Institutes of Health as the degree to which individuals have the capacity to obtain, process and understand basic health information and services they need to make appropriate health decisions. Patients with limited English proficiency (LEP) and/or limited health literacy are less able to access health care services, understand health-related information and follow health care instructions. Limited English proficiency and poor health literacy are associated with poor health outcomes and higher health care costs. Clinicians and patients need to be able to understand each other. If patients with limited English proficiency lack access to language assistance services, they will have a difficult time understanding the care they receive and will be less satisfied with services
steps that practices take when they assume that all patients may have difficulty comprehending health information and accessing health services. Health literacy universal precautions are aimed at:
verbal formats and graphic formats such as visual brochures, videos, infographics, and graphic demonstrations.
Pregnancy intention screening may take different forms depending on the patient’s needs and the relationship between the patient and her/his clinician. Regardless of the format, pregnancy intention screening should be patient-centered.
Counseling that is respectful of, and responsive to, individual patient preferences, needs and values. This approach saves time and encourages patient decision-making and responsibility.
Effective contraceptive counseling and education is a two-way process. By asking questions and listening to what patients
say, we experience bi-directional learning. Patient-centered counseling benefits patients because it addresses their concerns, focuses on their needs and results in positive health outcomes. It benefits clinicians by saving time, decreasing stress and frustration, and increasing effectiveness and professional engagement.
A range of factors can influence a patient’s choice of a contraceptive method. Personal preferences, relationship characteristics, social influences, pregnancy intentions, and cultural considerations may affect the decision-making process. The contraception care provider has an important role in assisting patients with their decisions. First, by listening to the patient—eliciting concerns, interests and goals related to pregnancy prevention. Then, by providing clear and accurate information about the full range of contraceptive options, emphasizing those most aligned with patient-expressed desires.
in this context, refers to patients assigned male at birth who are having sex with women.
Males are increasingly recognized as a key part of preventing unintended pregnancies, as well as planning and supporting healthy pregnancies. Several strategies can be used to increase their involvement in the spacing and timing of pregnancies.
a person in a period of human growth and development that occurs after childhood and before adulthood, from ages 10 to 19.
a person under the age of 18.
a person under the age of 24.
Ensure that all patients, particularly youth, are aware of the Oregon Confidential Communication Request law. This law gives patients enrolled in a private health insurance policy the right to request that protected health information is sent directly to them instead of the person who pays for health insurance.3
– Use billing procedures to maintain patient confidentiality. If this is not possible, advise the patient about the potential breach of confidentiality. Provide alternative billing options such as self-pay on a sliding fee scale.5
includes a choice of combination oral contraceptives (phasic and monophasic), at least one non-oral combination contraceptive (ring or patch), a progestin-only pill and injectable, IUD and IUS, sub-dermal implant, latex and non-latex male condoms, female condoms, two types of spermicide, diaphragm or cervical cap, Fertility Awareness Method (FAM), emergency contraception pills (ECP) for immediate use, information about abstinence and withdrawal, and information and referral for sterilization.
on the premises, such as in the clinic, in the building or on the campus, so that a patient does not have to travel to another location such as a separate retail pharmacy.
Contraceptive choice is an important aspect of quality care as patients may be more likely to select a method that fits her/his unique circumstances.
Many of the strategies and resources recommended in Component 2.2: Counseling and Education are relevant to this Component. The strategies below are also recommended to support patients and their use of contraception.
defined by The Beryl Institute as “the sum of all interactions, shaped by an organization’s culture, that influence client perceptions across the continuum of care.” (The Beryl Institute, http://www.theberylinstitute.org/?page=definingpatientexp)
refers to the initiation of contraception on the day of the visit.
refers to the average length of time in days between the day a patient makes a request for an appointment and the third next available appointment. The third next available appointment is used rather than the next available appointment because it is a more sensitive reflection of true appointment availability.
It is recommended that the Tool be used and completed by a team of staff members who are involved in the delivery of reproductive health services within the clinic, to ensure all staff roles are represented. Examples include clinicians, medical assistants, administrative and billing staff, reception and appointment schedulers, interpreters, lab and pharmacy staff, medical director, clinic manager, nurse supervisor, etc. Once your team is assembled:
Review the overview of the Oregon Guidance for the Provision of High-Quality Contraception Services: A Clinic Self-Assessment Tool. Or you can download the print version to review the full assessment.
Discuss the process and logistics for completing the Tool as a team. (Alternatively, the team may divide into several pairs or small groups to assess specific domains, followed by a team meeting to share and discuss results.) If more than one person from your clinic will be completing the assessment, you will need to use the same username and password as the person who registered.
Review each measure, discuss with team members and select the numbered response that best describes your clinic’s practice. Complete all measures in each component and all components in each domain. When you’ve completed an entire domain, click “Submit Domain.” You can complete the domains in whatever order you choose and can complete the assessment in more than one session.
If you have already submitted a domain, you can go back and change your answers. To save your new answers, click “Submit Domain” again
Once you’ve completed all four domains, the Tool will tabulate your scores and provide an overall score, along with the option to download your clinic’s custom summary report.
Consider the following guidance when completing the Tool:
Summarize the findings with your team and determine next steps:
If you have any questions, concerns, or feedback about the Clinic Self-Assessment Tool, please contact the Oregon Reproductive Health Program at: [email protected].