Using the person-centered contraceptive counseling (PCCC) measure for quality improvement

Abstract

Calls to develop performance measures that focus on patient experience of contraceptive care gathered momentum following the National Quality Forum's (NQF's) endorsement of contraceptive provision measures in 2016. Calls were motivated by several considerations, including recognition that intermediate outcome measures like contraceptive provision measures are imperfect proxies of quality and access. Additionally, selection of a contraceptive method is highly preference-sensitive and influenced by many factors separate from availability of contraceptive services, absence of financial barriers, and quality of contraceptive counseling. To optimize quality for patients, especially those from marginalized communities, healthcare organizations must center all health needs, not just those with the potential to affect future reproductive outcomes. Such a step entails conceptualizing health needs more broadly. The Person-Centered Contraceptive Counseling (PCCC) measure is a standalone patient-reported outcome performance measure that uses a 4-item scale to assess the three domains of person-centered contraceptive counseling: interpersonal connection, decision support, and adequate information. Endorsed by NQF in 2020, the PCCC is a tool that healthcare organizations may use to ensure that patients' experiences, needs, and preferences are assessed and prioritized. Though research on tandem use of the PCCC measure with contraceptive provision measures is in progress, organizations can begin collecting PCCC measure data and using it to improve the person-centeredness of contraceptive care they provide, with an eye towards advancing equity. Early adopters of the PCCC measure as a quality improvement tool have experiences and lessons-learned that can be leveraged and built upon.