Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #105083

Rivka Gordon, PA-C, MHS and Robyn Schryer, MPA. Ipas, 300 Market Street, Suite 200, Chapel Hill, NC 27516, 919-960-5637, gordonr@ipas.org

Ipas has developed a handbook, toolkit, and online professional mentoring program to assist clinicians in shifting uterine evacuation services out of the operating room and into outpatient clinics or emergency departments using the manual vacuum aspiration (MVA) procedure. In the fall of 2004, Ipas commissioned a qualitative study (1) to assess the status of abortion care and miscarriage management in selected U.S. hospitals and (2) to identify both the barriers faced and the strategies used by hospital clinicians wishing to improve treatment methods in these settings. Thirteen clinicians were interviewed working in different hospitals located in 10 states across the country. Eleven of the clinicians were OB/GYNs. The hospitals included both public and private institutions and all had residency programs in OB/GYN and other specialties. While all but one of the hospitals surveyed did not provide many on-site first-trimester abortions, all of the hospitals surveyed treat a high volume of missed or incomplete abortions. Most of the management of these miscarriages is taking place in the operating room, often using general anesthesia. However, research shows that managing miscarriages and early abortion using MVA in an outpatient setting is a safe, effective, quicker, and more cost effective model of delivering services. Ipas's technical assistance tools target the administrative, bureaucratic, and clinical barriers reported by clinicians who have been successful in improving services.

Learning Objectives: At the conclusion of this session, participants will be able to

• Recognize the need for and benefits to improving miscarriage management and first-trimester abortion care in selected U.S. hospitals.
• List 5 common administrative, bureaucratic, and clinical barriers to improving the quality of miscarriage management and first-trimester abortion care in hospital settings.
• Articulate 5 strategies for overcoming barriers to service-delivery improvements.
• Apply technical assistance tools from Ipas and other organizations to their own clinical setting in order to improve service-delivery.

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commertial supporters WITH THE EXCEPTION OF Rivka Gordon is an employee of Ipas. Ipas is a nonprofit organization and the manufacturer of manual vacuum aspiration instruments..