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

Area of Science:

• Rheumatology
• Quality Improvement
• Women's Health

Background:

• Contraception screening and documentation are crucial for reproductive-aged women.
• Academic rheumatology clinics serve a population that may benefit from enhanced reproductive health services.

Purpose of the Study:

• To increase provider screening and documentation of contraception use for reproductive-aged women in an academic rheumatology fellows' clinic.
• To achieve a documentation rate greater than 50% within 24 weeks and sustain it for one year.

Main Methods:

• A multidisciplinary team implemented six interventional cycles over 24 weeks.
• Key interventions included educational sessions, documentation instruction, scripts, and email reminders.
• Primary outcome was the percentage of eligible visits with documented contraception information; smoking status documentation was a balancing measure.

Main Results:

• Contraception documentation increased from 11% to 54% within 24 weeks.
• The rate was sustained at 50% at the one-year mark.
• Smoking status documentation remained high (median 88%), and non-MD clinical staff were primary documenters (median 92%).

Conclusions:

• A multicycle educational intervention effectively increased and sustained contraception documentation in an academic rheumatology clinic.
• Future efforts should focus on enhancing contraception counseling and referrals for high-risk patients in rheumatology settings.