Best Practices for Family Planning Clinics Print

This needs and assets assessment tool offers clinic administrators and staff an overview of “best practices” for family planning service delivery. Categorized into sections, the tool gives you an opportunity to learn about the latest research and best practices and then, using this information, rate how your clinic fares.  

The tool draws on research from four key sources:

  • Alford S. From Research to Practice: Youth-Friendly Reproductive and Sexual Health Services. Washington, DC: Advocates for Youth, 2009.
  • Alford S. Science and Success.  Washington, DC: Advocates for Youth, 2008.
  • Burlew R, Philliber S. What Helps in Providing Contraceptive Services for Teens. Washington, DC: National Campaign to Prevent Teen Pregnancy, 2006.
  • Kirby D. Emerging Answers 2007: Research Findings on Programs to Reduce Teen Pregnancy and Sexually Transmitted Diseases. Washington, DC: National Campaign, 2007.
It allows you to assess whether best practices are in place in your clinic with respect to: 
  • Confidentiality
  • Respectful treatment
  • Screening and counseling
  • Integrated services
  • Cultural competency
  • Accessible and affordable care
  • Reproductive and sexual health care
  • Staff development
  • Services for young men
  • Parent-child communication
Please indicate the degree to which you feel the organization practices each standard by circling the appropriate rating (1) to (5) where 1= never, 2= rarely, 3= sometimes, 4= often, and 5= always. Total your scores for each section to create an overall “category score.”

 

 I.  Confidentiality

Best Practice: Assure that Young People Have Confidential Access to Contraceptive Services.
   Never   
 Rarely   
 Sometimes   
 Often   
 Always
1. Staff has a clear understanding of the state’s laws in relation to informed consent, client confidentiality, and parental notification.  1  2  3  4  5
2. Every clinic staff member, including receptionists, medical assistants, and technicians, is trained about the importance of guarding adolescents’ confidentiality.
 1  2  3  4  5
3. We emphasize the protections rather than limits of confidentiality when interacting with teens.  1  2  3  4  5
 4. We make sure always to have some counseling time alone with adolescent patients, even when they are accompanied to the appointment by a parent or a partner. Staff treats unaccompanied minors as well.
 1  2  3  4  5
5. We refer minors to a pharmacy where their confidentiality will be respected    
 1  2  3  4  5
6. We give extra assurances of confidentiality to HIV-positive youth, undocumented youth, older adolescents, GLBTQ youth, and pregnant and parenting teens.    
 1  2  3  4  5
My overall score for this category is (add up all the numbers):  

 

 II.  Respectful Treatment

Best Practice: Treat Teens with Dignity and Respect.

   Never   
 Rarely   
 Sometimes   
 Often   
 Always
1. Every staff member – from clinicians to receptionists – receives training in adolescent development and in treating youth respectfully. Staff is comfortable working with youth.
 1  2  3  4  5
2. Staff schedules longer visits with adolescent clients than with adults.
 1  2  3  4  5
3. All clinicians and counselors are trained in how to raise sensitive issues, including sexual health, condom and contraceptive use, substance use, interpersonal violence, and mental health.  1  2  3  4  5
4. Clinic staff treat every youth as a whole person and involves teens in their own health management.
 1  2  3  4  5
5. A clinic staff member always asks teen clients if they want a chaperone present during an examination.
  1  2  3  4  5
6. Clinicians explain the reasons for a particular test as well as what is involved in the test.
 1  2  3  4  5
My overall score for this category is (add up all the numbers):  

 

III.  Integrated Care

Best Practice: Use an Integrated, Multidisciplinary, Holistic Approach to Health Care.
   Never   
 Rarely   
 Sometimes   
 Often   
 Always
1. We establish protocols to ensure that youth receive preventive counseling as recommended by GAPS (American Medical Association) or other major medical organizations.  1  2  3  4  5
2. We have protocols that ensure that clinicians screen and counsel every adolescent. We follow the recommendations of the American Medical Association, Society for Adolescent Medicine, and/or American Academy of Pediatrics.
 1  2  3  4  5
3. We screen every teen for depression, interpersonal violence, and a history of abuse because we know that these factors can have a profound effect on adolescents’ risk-taking and health-seeking behaviors.
 1  2  3  4  5
4. We screen every teen for current risk-taking behaviors, including substance use, unprotected sex, exposure to or participation in violent behaviors, poor nutrition, inadequate exercise, and social problems.
  1  2  3  4  5
5. We recognize that some teens, including teen parents and those in foster care, homeless shelters, juvenile detention centers, and substance abuse programs, have higher rates of risk-taking than other teens. Therefore, we set up strong referral systems, co-locate services, and/or establish collaborative partnerships with agencies who serve these youth.
  1  2  3  4  5
6. We develop links with school-based health clinics, which we know are especially effective in serving teens but are often unable to provide contraceptive and family planning services.
 1  2  3  4  5
7. Recognizing that many youth use the hospital emergency department as their usual source of care and, thus, may not receive comprehensive care, we connect with local ER’s so they can refer youth to us for family planning and other care.
 1  2  3  4  5
8. To the extent possible, we try to ensure continuity of care by making every effort to have teens see the same counselor and/or clinicians at every appointment.
 1  2  3  4  5
9. The breadth of the clinic’s services is widely advertised. Clinic staff actively use “in-reach” as well as outreach by asking adolescent clients to recommend services to their friends.
  1  2  3  4  5
10. We make referral appointments for adolescents and ensure that they know exactly where and when to go, giving them clear directions, assurances of continuing confidentiality and information about fees, if any.
 1  2  3  4  5
11. We provide a sheet of paper with the adolescent’s correctly spelled diagnosis and medications, if any, along with reliable, accurate consumer health information Web sites.
 1  2  3  4  5
12. We are aware that integrated care is especially important to some populations of youth, especially young men, pregnant teens, GLBTQ youth, HIV-positive adolescents, and sexual assault survivors.
  1  2  3  4  5
My overall score for this category is (add up all the numbers):  

 

 IV.  Cultural Competency

Best Practice: Offer Culturally Competent Services and Tailor Services to Meet the Needs of Teen Clients.
   Never   
 Rarely   
 Sometimes   
 Often   
 Always
1. We have ongoing training for all staff regarding cultural norms, adolescent development, sexual orientation and gender identity, and cultural competency.
 1  2  3  4  5
2. We have clear, unambiguous policies against discrimination on the basis of sex, age, race/ethnicity, sexual orientation, religion, and gender identity. We ensure that the clinic or practice is a safe place for all clients and staff.
  1  2  3  4  5
3. We hire staff who represent our client population and who are diverse in many ways, including gender and ethnicity. We pay attention to gender role dynamics between staff and clients.
 1  2  3  4  5
4. We ensure that staff can communicate with clients in their own language(s). We ensure that bi-lingual staff is available, either during all operating hours or at set times and on set days.
 1  2  3  4  5
5. We ensure that age-appropriate, high quality consumer health materials and consent forms are available in all the languages that clients speak and for various reading levels, including low literacy.
 1  2  3  4  5

6. We involve young people in assessing the policies and services offered by the clinic and we take their recommendations seriously.
  1  2  3  4  5
7. Our waiting rooms and examining rooms have a gender neutral décor, reassuring both young men and young women that they belong there and are welcome.
  1  2  3  4  5
My overall score for this category is (add up all the numbers):  

 

 V.  Accessible and Affordable Services

Best Practice: Ensure that Services are Affordable and Accessible for Teens.
   Never   
 Rarely   
 Sometimes   
 Often   
 Always
1. We offer transportation vouchers to youth and/or we link with community clinics in the area so that youth can use a clinic closer to their home,  school, or work.  1  2  3  4  5

2. We offer a special help-line that adolescents can use to inquire about services, to make appointments, and to request follow-up care.
  1  2  3  4  5
3. We offer flexible hours for adolescents including appointments in the evening and on weekends. We accept walk-in appointments.  1  2  3  4  5
4. We get a cell number and/or private e-mail address for youth. We contact youth within 24 hours with their test results and keep a confidential log book to document follow-up, treatment, and partner notifications
  1  2  3  4  5
5. We offer free or greatly reduced fees for services to teens.
  1  2  3  4  5
6. We dispense free or low cost prescriptions to teens.
  1  2  3  4  5
7. Where possible, we offer private billing accounts for teens to ensure confidentiality.
 1  2  3  4  5
8. We stock exam rooms (and /or the waiting room) with baskets of free condoms along with signs saying that youth are free to take as many as they feel they need.
  1  2  3  4  5
My overall score for this category is (add up all the numbers):  

 

 VI.  Reproductive & Sexual Health Services

Best Practice: Establish Teen-Specific Protocols for Reproductive & Sexual Health Services.

   Never   
 Rarely   
 Sometimes   
 Often   
 Always
1. We use a teen-friendly standardized form for eliciting sexual history.
 1  2  3  4  5
2. We offer adolescent women a complete array of hormonal contraceptive methods. When an adolescent chooses the pill, patch, or ring, we encourage her to begin her method immediately and to use condoms for additional protection against pregnancy for the first seven days after she has begun.
 1  2  3  4  5
3. We explain the difference between the relative risks and the absolute risks associated with contraceptive options.
 1  2  3  4  5
4. We stress the importance of using dual protection – that is, of using hormonal contraception or other barrier method to prevent pregnancy and condoms to reduce the risk of HIV and STIs to all female clients, regardless of their sexual orientation. We counsel all sexually active youth to use condoms or dental dams at every act of sex to prevent or lessen the risk of infection with STIs, including HIV.
 1  2  3  4  5
5. We don’t require a pelvic exam before prescribing or dispensing hormonal contraception to adolescents. We do the first Pap test three years after the first experience of vaginal intercourse or at 21 years of age, whichever comes first.
 1  2  3  4  5
6. We don’t require a pregnancy test before offering emergency contraception. 
 1  2  3  4  5
7. For purposes of partner notification, we ask about sexual partners for the previous two weeks to one month for herpes and most bacterial infections, in the past two months for chlamydia and gonorrhea infections, and in the past year for HIV infection. We do not limit screening to symptomatic clients.
 1  2  3  4  5
8. We screen consistently for Chlamydia and Gonorrhea, using urine-based testing.
 1  2  3  4  5
My overall score for this category is (add up all the numbers):  

 

 VII.  Services for Young Men

Best Practice: Recognize that young men have sexual and reproductive health needs of their own.
   Never   
 Rarely   
 Sometimes   
 Often   
 Always
1. We offer holistic care to all young men, regardless of their sexual orientation, that addresses their physical, emotional, and social health.
 1  2  3  4  5
2. We link with other community health clinics and agencies so that other agencies can refer young men to us and we can easily and readily refer young men to nearby care in venues where they will feel that no one will know why they are there.
  1  2  3  4  5
3. We train all clinic staff about the importance of guarding male adolescents’ confidentiality, especially with regard to their peers  1  2  3  4  5
4. We advertise the breadth of the clinic’s services, especially in venues where young men congregate. To make our services known, we use ‘in-reach’ as well as outreach, asking our clients to recommend our services to young men they know.
  1  2  3  4  5
5. We screen all young men under age 25 for Chlamydia and gonorrhea, except when the prevalence in our client population is less than two percent. We consider separately the populations of young men who do and do not have sex with other men. We do not limit screening to symptomatic males.
  1  2  3  4  5
My overall score for this category is (add up all the numbers):  

 

 VIII.  Parent-Child Communication

Best Practice:  Help parents support their teen’s reproductive and sexual health needs. 

   Never   
 Rarely   
 Sometimes   
 Often   
 Always
1. We advertise and offer workshops for parents on how to talk with their teens and younger children about sensitive sexual health issues.
 1  2  3  4  5
2. We work with other agencies in our community to promote parenting skills and to prevent teen pregnancy, adolescent substance use, and other adolescent risk behaviors.
  1  2  3  4  5
3. We offer pamphlets, Web information, and other materials, in a variety of languages and reading levels to help parents talk with adolescents about sexuality and other sensitive health issues.  1  2  3  4  5
4. We help parents understand the importance of confidential care for adolescents.
  1  2  3  4  5
My overall score for this category is (add up all the numbers):  


Tags: Topic: Access to Health Care Services Type: From Research to Practice