Upstream Patient Survey Overview
It is essential that patients receive high-quality, person-centered contraceptive counseling and care that is free from coercion.
Why is the survey important?
Upstream conducts patient surveys at Upstream-trained health centers to arm and inform our patient-centered approach by learning directly from patients about their experience with contraceptive care, their satisfaction with contraceptive counseling, and patient voluntarism. The patient survey provides critical information about the patient experience and complements the EHR-based Upstream Family Planning Measures.
Key outcomes of interest include:
Satisfaction and person centeredness of contraceptive counseling
Comprehensiveness of contraceptive counseling
Patient voluntarism around contraceptive method selection
Same-day access to contraceptive methods and satisfaction with timing
How is this survey conducted?
The patient survey is administered virtually. To reduce the burden on our health center partners and to ensure that Upstream never sees PHI throughout the surveying process, Upstream has partnered with a third party data reporting and visualization platform called Azara for the survey delivery and data collection. Azara is connected directly to the agency EHR and using this platform will identify eligible patients and invite them to take the online survey via a link sent in a text message. The patient survey will be conducted on an on-going basis during the duration of an agency’s engagement with Upstream.
The survey is anonymous and voluntary. The survey takes approximately 5−10 minutes to complete and respondents will be compensated for their participation with a $20 e-gift card from a list of vendor options (excluding big-box stores and cash-equivalent options). The survey is available in English, Spanish, Portuguese, Simplified Chinese, Traditional Chinese, Vietnamese, Haitian Creole, Arabic, French, Laotian, Somali, and Russian.
Who is surveyed?
Upstream will work with you to determine which clinical sites at your health center should participate in the survey. After an eligible patient (ages 18−44, female assigned at birth) has a qualifying encounter (reproductive health or primary care related) Azara invites them via text message to take the survey. Based on initial self reported screening questions, patients who are outside of the 18−44 age range, patients who are currently pregnant, who have had a hysterectomy, who are peri- or post- menopausal, sterile, or infertile will be exited from the survey. Eligible patients will only be invited up to once in a 6 month period of time.
How are patients notified?
Eligible patients with a qualifying encounter will be invited to participate in the survey around 24 hours after their encounter chart is closed. The survey invitation language will specify that the survey is being conducted by Upstream USA to learn about the patient’s most recent visit (including telehealth visits) at your health center. Patients can choose not to be contacted again by responding ‘STOP’ to the text message invitation. If an invitee does not choose ‘STOP’ and does not complete the survey after the initial invitation, a reminder will be sent 48 hours after the first text message. If the invitee does not choose ‘STOP’ and does not complete the survey after the 1st reminder, a second and final reminder will be sent 96 hours after the first text message.
Upstream has prepared sample language that can be customized and used to notify patients about the survey via a patient portal/email or using a flyer. Additionally we have notification language and talking points for your sta, including a script for front desk sta if asked about the survey. Upstream will work with each agency to ensure that an approach that best fits your health center’s needs is in place.
How are the results used?
Your Upstream team will meet with your team to review the patient survey results to ensure patient experience is a driver in your practice transformation journey. We will look at results at two points in time: baseline or pre-training results, and again 9 months after you conclude your Upstream technical assistance. We use the survey data to:
Better understand how patient experiences may have changed or been maintained during the course of the Upstream intervention.
Gather additional insights regarding care from open-ended feedback responses.