摘要：Background and Objectives: High rates of unintended pregnancy and poor pregnancy outcomes can be ameliorated by improved access to contraceptive and preconception care. Little data exists regarding application of routine pregnancy intention (PI) screening to reduce unintended pregnancy and optimize preconception health in family medicine residency education. This quality improvement (QI) project evaluated the rate at which family medicine residents and providers (attending physicians and nurse practitioners) addressed women’s unmet reproductive health needs identified through PI screening. Methods: In April 2015 routine PI screening was implemented at a teaching health center. From April through July chart review was performed of patient encounters for eligible women age 12 to 45 to assess the rate of addressing unmet reproductive health needs, including contraception and/or preconception care, based on provider documentation. Individual resident and provider performance feedback was given monthly. Follow-up chart review was performed in February 2016 to evaluate postintervention performance. Results: Residents and providers had 1,676 eligible patient visits, and respectively increased their rates of addressing unmet reproductive health care needs from 47% to 48% in April to 66% to 67% in July 2015. Residents had a sustained increased rate of 62% in February 2016 ( P =0.0139), while providers did not. Conclusions: Resident and provider rates of addressing women’s unmet reproductive health needs increased with a simple QI intervention. Residents, but not providers, sustained these rates at 6-month follow-up. Routine PI screening combined with performance evaluation is a promising approach to promote preventive reproductive health education in family medicine residency teaching clinics, but requires further study of long-term outcomes.
