Operation PINC: Process Improvement for Non-Delayed Contraception.

Abstract

The Department of Defense is under intense scrutiny for the reported increased unintended pregnancy rate in active duty women. To minimize barriers to contraception and improve access to care for family planning needs, a novel full-service walk-in clinic for contraception was created. The objective of this study is to describe utilization of a walk-in contraceptive clinic including patient demographics, long-acting reversible contraception (LARC) initiation rates, projected cost savings, and patient satisfaction within the first 6 months of operation. This is a prospective cohort and quality improvement study of 2,207 women presenting to a same day full-service contraception clinic from February 1, 2016, to August 31, 2016. Patient volume, demographics of participants, type of contraceptive service provided, LARC initiation, and LARC removal rates were recorded prospectively. Outcomes were compared with the Student t-test or χ2 test as appropriate. The mean age of participants seen in the first 6 months was 25 years; 70% of attendees were active duty women and 88% were enlisted service members. LARC initiation increased from 12% to 39%. Operation PINC is a cost savings initiative, saving the Navy a potential $15 million a year and 2.7 million lost person-hours by preventing unintended pregnancy. Offering same day contraceptive services is a potential cost savings, patient satisfier, which targets women at risk for unintended pregnancy, improves LARC initiation, and has the potential to improve operational readiness of female service members and ultimately decrease unintended pregnancy rates.