The visit-specific Person-Centered Contraceptive counseling (PCCC) measure has been used primarily to assess the person-centeredness of care directly after a patient’s visit. When sites implement the visit-specific PCCC survey, patients are given a survey on the care they received during a particular visit. Surveying after a clinic visit allows sites to understand the quality of the care patients receive at the clinic- and provider-level. While the visit-specific measure is optimized for quality improvement, it is not ideal for population-level sampling at a health plan or state level.
PCRHP worked to adapt the visit-specific PCCC for retrospective data collection on patient experience of contraceptive counseling to enhance measurement of and attention to patient-centered contraceptive care. Insurance plans, health systems, and MCOs routinely send out surveys to patients to gather information on their healthcare experiences looking back on a certain time period. These retrospective surveys provide opportunities to include patient voices to improve the quality of care. This retrospective PCCC measure (PCCC-RS) allows for population-level sampling at the level of health care plans and states.
PCCC-RS Survey
Think about your appointments when you talked about contraception or pregnancy prevention in the last 6 months.
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Overall, how do you think the member(s) of the healthcare team(s) (including any doctor, nurse, medical assistant, etc.) did? Please rate them on each of the following. |
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Respecting me as a person |
1 |
2 |
3 |
4 |
5 |
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Letting me say what mattered to me about my birth control method |
1 |
2 |
3 |
4 |
5 |
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Taking my preferences about my birth control seriously |
1 |
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3 |
4 |
5 |
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Giving me enough information to make the best decision about my birth control method |
1 |
2 |
3 |
4 |
5 |
Adapting the PCCC Measure for Retrospective Use
The PCRHP team worked to adapt the PCCC measure for retrospective use through a modified Delphi process with an expert workgroup and patient stakeholder group. This adaptation focused on modifying the question stem and measure instructions for use in retrospective surveys. No modifications were made to the survey items or response categories. See the figure below for more information on our modified Delphi process to adapt the PCCC measure for retrospective use.
Figure 1 Modified Delphi Process
Measure Validation and Endorsement
Following adaption, the PCCC-RS measure was piloted with 12 Planned Parenthood Federation of America affiliates and with Family Planning Only waiver recipients at Washington State Health Care Authority. The PCCC-RS measure is currently undergoing validation and will be submitted for endorsement to the Partnership for Quality Management.
The PCCC-RS measure in English and Spanish
The PCCC-RS has been translated for use in Spanish. Our team is interested in adapting to other languages in the future and welcomes inquiries or sharing of translated versions.
How to Analyze and Interpret PCCC-RS Measure Results
PCCC-RS responses are aggregated and reported as a percentage of patients who marked “excellent” on all four items. The items and response categories for the PCCC-RS remains the same as the visit specific and calculation is as follows:
Calculating the PCCC-RS Measure Result
The PCCC-RS measure result is calculated as the percentage of patients who gave a top score ("5") on all four items on the PCCC-RS scale.
The recommended minimum panel size is 150 patient responses at the state- and plan-level.
Interpreting the PCCC-RS Measure Result
Initial testing is underway to understand what a suitable benchmark score is for the PCCC-RS measure.
Disaggregating PCCC-RS scores
While including demographic questions as part of the PCCC-RS measure is not required, being able to disaggregate by certain demographic characteristics can identify inequities requiring attention.