Evidence map›Paper›PMID 33076890›Full record

ArticleBMC health services research2020

Examining the pace of change in contraceptive practices in abortion services - a follow-up case study of a quality improvement collaborative.

Helena Kilander, Jan Brynhildsen, Siw Alehagen, Johan Thor

Open access · goldAbstract read
In one paragraph

Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.5field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Helena KilanderDepartment of Obstetrics and Gynaecology, Eksjö Hospital, Region Jönköping County, Sweden. helena.kilander@rjl.se.ORCID http://orcid.org/0000-0003-3597-9004
Jan BrynhildsenDepartment of Obstetrics and Gynaecology and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Siw AlehagenDepartment of Health, Medicine and Caring Sciences , Linköping University, Linköping, Sweden.
Johan ThorJönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
Linköping University · SEJönköping University · SE

Funding

Forskningsrådet i Sydöstra Sverige 752041Futurum - Akademin för Hälsa och Vård, Region Jönköpings läns 670161
6 · The paper itself

Abstract

backgroundAmong all women who experienced an abortion in Sweden 2017, 45% had previously underwent at least one abortion. This phenomenon of increasing rates of repeat abortions stimulated efforts to improve contraceptive services through a Quality Improvement Collaborative (QIC) with user involvement. The participating teams had difficulty in coordinating access post-abortion to the most effective contraception, Long-acting reversible contraception (LARC), during the eight-month QIC. This prompted questions about the pace of change in contraceptive services post-abortion. The aim of the study is to evaluate the evolution and impact of QIC changes regarding patient outcomes, system performance and professional development over 12 months after a QIC designed to enhance contraceptive services in the context of abortion.

methodsThis follow-up case study involves three multi-professional teams from abortion services at three hospitals in Sweden, which participated in a QIC during 2017. We integrated qualitative data on the evolution of changes and quantitative data regarding the monthly proportion of women initiating LARC, analysed in statistical control charts from before the QIC up until 12 months after its conclusion.

resultsTeams A and B increased the average proportion of women who initiated LARC within 30 days post abortion in the 12 months after the QIC; Team A 16-25%; Team B 20-34%. Team C achieved more than 50% in individual months but not consistently in the Post-QIC period. Elusive during the QIC, they now could offer timely appointments for women to initiate LARC more frequently. Team members reported continued focus on how to create trustful relationships when counseling women. They described improved teamwork, leadership support and impact on organizing appointments for initiating LARC following the QIC.

conclusionsQIC teams further improved women's timely access to LARC post abortion through continued changes in services 12 months after the QIC, demonstrating that the 8-month QIC was too short for all changes to materialize. Teams simultaneously improved women's reproductive health, health services, and professional development.

Indexed as

Abortion, InducedFemaleFollow-Up StudiesHealth Services AccessibilityHospitalsHumansLong-Acting Reversible ContraceptionOrganizational Case StudiesPregnancyQuality ImprovementReproductive Health ServicesSwedenContraceptive counsellingHealth services accessibilityLong- acting reversible contraceptionProfessional development and pregnancy terminationQuality improvementSystem performance

Identifiers

PMID33076890
PMCPMC7574423
OpenAlexW3093156272

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.