The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #71328

Anna Kaniauskene, MS¹, Lesli Leone Uebel, MPH², Laura Faherty, MPH³, John Beleutz, MPH⁴, Sharlyn Hansen, MN, RN⁵, and Amy Shire, MPH¹. (1) EngenderHealth, 440 Ninth Avenue, New York, NY 10001, (2) Family Planning Program, DHS, 800 NE Oregon Street, Suite 850, Portland, OR 97232, (3) Oregon State Health Department, 2100 Mount Hood Street, The Dalles, OR 97058, (4) Population Services International, 406 Main Street, Suite 423, Watsonville, CA 95076, (5) Office of Family Planning, Clinical Services Section, California Department of Health Services, 714 P Street, Room 440, Sacramento, CA 95814, 916-657-0767, Shansen@dhs.ca.gov

COPE is a continuous, participatory quality improvement process created by EngenderHealth for reproductive health providers, using self-assessment tools to identify problems, analyze root causes, and develop and implement practical solutions to those problems. Originally designed for low-resource settings in developing countries, COPE was recently introduced in Oregon and California, with very positive results. In spring 2001 Oregon State Health Services and Population Services International (PSI) asked EngenderHealth to pilot COPE in two family planning clinics. In introductory exercises, 16 problems were identified in one clinic and 28 problems in the other; within six months, staff in both clinics had solved all problems. Service quality and work conditions noticeably improved in each site. Both clinics continue to use COPE routinely, and COPE has been introduced in fifteen additional clinics, public and private. Eleven trained facilitators are expanding COPE statewide. Building on Oregon’s experience, with similar goals of expanding access to and improving the quality of family planning services, the California Department of Health Services’ Office of Family Planning (OFP) and PSI contracted with EngenderHealth to train COPE facilitators and offer COPE to 710 publicly-funded clinics. Sustainability of the QI process was built in from its inception through a comprehensive approach including: intensive skills development of core COPE facilitators; and a detailed implementation plan delineating COPE coordinators’ responsibilities, marketing strategies, phased introductions to clinics statewide, training of on-site facilitators and follow-up assistance in monitoring and evaluation. Results from both states’ experiences will be presented in a case study analyzing COPE implementation models.

Learning Objectives:

At the conclusion of the session,participants will be able to:
• describe a participatory quality improvement (QI)process, COPE(c)(Client Oriented, Provider Efficient), and the results of its use in Oregon and California.
• Describe elements of successful models for introducing and scaling up the COPE process.

Keywords: Reproductive Health, Quality Improvement

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.