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Strengthening the evidence base for maternal and child health programs

New: MCH Best strategies database for sample ESMs

Evidence Tools
MCH Best. NPM 1: Well-Woman Visit

MCH Best Logo well-woman visit

Strategy. Designated Clinics/Extended Hours

Approach. Increase access and visibility to clinics that offer extended hours of service within close proximity to MCH populations.

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Overview.Increase access to and visibility of clinics that offer extended hours of service within close proximity to MCH populations.

Evidence. Moderate. Multiple access, scheduling, and time-related factors contribute to 'missed opportunities' in providing comprehensive preventive care. "Designated clinics and extended hours have been shown to address some of thes missed opportunities in providing preventative services to women."1 Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Provider/Practice.

Outcome. Percent of women with a past year preventive visit. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.

Examples from the Field. Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

The Role of Title V. Title V agencies can support organizations that offer extended hours through a number of approaches:

For additional suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies.

Sample ESMs. Using the approach “Increase access and visibility to clinics that offer extended hours of service within close proximity to MCH populations,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework:

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of clinics that offer extended clinic hours within close proximity to MCH populations.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of clinics that offer extended clinic ours within close proximity to MCH populations.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of women seen in clinics who report extended hours were instrumental in attending an annual preventive visit.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of women seen clinics who report extended hours were instrumental in attending an annual preventive visit.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


Reference:

1 Singh, M. K., Einstadter, D., & Lawrence, R. (2010). A structured women's preventive health clinic for residents: a quality improvement project designed to meet training needs and improve cervical cancer screening rates. Qual Saf Health Care, 19(5), e45-e45.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.