First Stage: Exploration

The Exploration stage is the first and most important in assessing and establishing the foundation for a successful immediate postpartum LARC program.

Key Steps by Department:

Key steps by task:

1. Identify project champions

Examples of project champion roles may include physicians, nursing, midwifery, lactation, pharmacy, hospital executives, hospital or departmental administration, finance, billing/coding, business coordinators, managers, medical records, and/or information systems. Clinical, pharmacy, and financial champions are often the most important.

It is common and recommended that a physician or another clinician brings the idea of immediate postpartum LARC to the rest of the hospital and recruits other important individuals

2. Provide clinical evidence to educate others

Clinicians may educate other team members about immediate postpartum LARC, the clinical benefits, and the rationale for providing such a program.

Our Immediate Postpartum LARC Resource Digest provides references with answers to common clinical questions.

3. Verify insurance participation

Individuals from pharmacy and/or finance or billing may require payment verification from payers.

The ACOG LARC Program tracks all state Medicaid reimbursement policies here.

4. Obtain Rembursement Reassurance and Verify Payment

Individuals from pharmacy and/or finance or billing may request detailed information about expected device costs and reimbursement levels. Look to the manufacturers for information on device cost and your state Medicaid program for reimbursement information.

5. Confirm appropriate administrative awareness

This step is hospital-specific. Every hospital will have a different level of administrative involvement appropriate for its immediate postpartum LARC program. Education of non-clinical administrators about the importance of immediate postpartum LARC could be an important step.

6. Assemble immediate postpartum LARC team and plan for ongoing communication

Establishing a project team and communication plan is the next step for successful program implementation. Individuals with clinical, pharmacy, and financial perspectives often comprise the core of the immediate postpartum LARC team.

Clear roles and responsibilities and a communication plan become important to prepare for implementation amid competing priorities. This may occur within established contexts such as service-level meetings, or teams may create an immediate postpartum LARC team with its own communication schedule.

Find more implementation resources here.

Citation: Hofler LG, Cordes S, Cwiak CA, Goedken P, Jamieson DJ, Kottke M. Implementing immediate postpartum long-acting reversible contraception programs. Obstet Gynecol 2017;129:3-9. Reprinted with permission from Wolters Kluwer Health, Inc.