Evidence-based research supports the use of a stage-based approach for successfully and sustainably implementing LARC immediately postpartum. One Study, “Implementing Immediate Postpartum Long-Acting Reversible Contraception Programs” by Hofler, et al. found that
“Hospital teams report that implementing immediate postpartum LARC programs involved multiple departments and a number of important steps to consider. A stage-based approach to implementation and a standardized guide detailing these steps may provide the necessary structure for the complex process of implementing immediate postpartum LARC programs in the hospital setting.”
“lack of knowledge about LARC, financial concerns, and competing priorities were common barriers to program implementation. Hospitals that successfully implemented immediate postpartum LARC programs did so with a multidisciplinary approach. These hospitals more easily navigated barriers and unexpected steps using clear communication and problem-solving among team members.”
The three stages of immediate postpartum LARC implementation include Exploration, Installation, and Implementation and Sustainability.
Each of the three implementation stages is organized by the departments that may be involved in the implementation process and outlines potential tasks for each department. Different hospitals will have different implementation team members working on these steps, who in turn may involve other individuals from their departments as needed.
|Department/Expertise||Potential Implementation Team Members|
|Clinical||Physicians, nurses (L&D & postpartum), midwives, or clinicians with administrative roles
Note: Some clinicians may hold formal roles on immediate postpartum LARC implementation teams. Others may be akin to “champions” who maintain the momentum and clinical relevance throughout implementation
|Pharmacy||Pharmacy directors, managers, or pharmacists dedicated to inpatient obstetrics|
|Finance or Billing||Individuals from revenue cycle management, financial administration, billing, coding, or similar business departments|
|Information Technology (IT) or Electronic Health Records (EHR)||EHR team or IT personnel knowledgeable about the EHR and billing software used by their hospital|
|Others to consider||OBGYN Department Chair, Medical Director, OBGYN and/or Family Medicine Residency Director, Family Planning Fellowship Director, Ryan Residency Training Program Director, lactation consultants, office staff, quality or compliance officer, other hospital leadership and/or representatives from private practices|
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.