Providing High-Quality Services – NFPRHA
Issues · Service Delivery

Providing
High-Quality Services

Providing high-quality services is a core tenant of the Title X family planning program — emphasizing evidence-based, person-centered sexual and reproductive health care grounded in the 2024 Quality Family Planning Services (QFP) guidelines and nationally recognized standards of care.

Providing high-quality services is a core tenant of the Title X family planning program. The program has long emphasized the delivery of evidence-based, person-centered sexual and reproductive health care grounded in the latest clinical evidence and nationally recognized standards of care, including the 2024 Quality Family Planning Services (QFP) guidelines. As health care and payment reform models continue to evolve, quality measurement and improvement remain a top priority in advancing equitable, inclusive, and high-quality care.

NFPRHA's Work: NFPRHA supports its membership to provide high-quality services in the following areas: clinical protocols development, quality measurement, health center efficiency, and alternative delivery models.

Quality Family Planning (QFP) Resources
Clinical Practice & Service Delivery
Delivering Inclusive Care for LGBTQ People
Health Center Operations

At a time of significant change across the service delivery landscape, publicly funded family planning providers are balancing increasing operational demands with a continued commitment to equitable, evidence-based, person-centered care. Strengthening workflows, reducing administrative burden, and improving efficiency are important strategies for maintaining access, supporting staff, and meeting patients' evolving needs. Developing and maintaining evidence-based clinical protocols also helps promote consistency in care delivery, support quality improvement efforts, and ensure services reflect current clinical standards and best practices.

NFPRHA's Work: NFPRHA works to support its membership to develop and implement strategies to streamline clinical and administrative operations, including efforts to develop and maintain evidence-based clinical protocols that promote high-quality and consistent service delivery.

Clinic Efficiency Tools
Word · Excel · PDF
Administrative Tracking Tool
Measures the length of time of administrative components of a patient visit. Supports collection of data on face-to-face and non-face-to-face patient-related activities, helping identify bottlenecks in patient flow, reduce cycle and wait times, and optimize staffing (December 2019).
PDF · Excel
Evaluates appointment trends by time of day and day of week, including total appointments seen, walk-ins, and no-show rates. Helps identify and minimize bottlenecks and increase capacity to accommodate walk-ins (January 2019).
Word · Excel · PDF
Cycle Time Tool
Measures the total length of time of an average patient visit including wait time. Helps health care organizations assess appointment schedule templates, identify bottlenecks, and monitor quality improvement activities. Can compare data across multiple sites and against benchmarks (May 2019).
PDF · Excel
Exam Room Study Tool
Measures the length of time of the clinical component of a patient visit. Tracks time clinical staff spend with patients at a specific exam room or location, helping identify bottlenecks and opportunities to decrease average clinician contact time through task-shifting (December 2019).
Word
Observations from the Patient Perspective Tool
Examines operations from the patient's perspective, considering gaps between optimal and actual patient experience, opportunities for streamlining visits, and other improvement opportunities (December 2019).
Word · Excel · PDF
Phone Call Tracking Tool
Measures the volume and nature of incoming phone calls to assess how they impact workflow and cycle time. Helps develop triage systems or contingency plans for handling incoming phone calls more efficiently (December 2019).
PDF
Guidance on how to determine which processes to study, how to create flow charts, questions to consider in analysis, and steps for redesigning processes to achieve better outcomes. Helps identify bottlenecks that produce longer wait and cycle times (January 2019).
Word · Excel · PDF
Provider Activity Audit Tool
Tracks time a clinician is not in direct contact with patients, identifying opportunities to increase clinician capacity and instances where other team members may better support clinicians (March 2019).
Word · Excel · PDF
Provider Interruption Tool
Measures the volume and nature of clinician interruptions during patient visits. Information can be used to assess how interruptions impact cycle time and clinician productivity (December 2019).
Word · PDF
Visit Activity Tool
Records information about activities comprising standard visits for each visit type to identify opportunities to streamline workflow, ensure team members operate at the top of their licenses, and detect missed or unnecessary tasks (January 2019).
Policies & Protocols
A guide for effectively developing and maintaining an organization's policies and procedures (September 2019).
A template protocol for the testing and treatment of syphilis. Designed to assist organizations in creating a local protocol for a family planning health center (April 2024).
A checklist of recommended clinical protocols for providers of contraceptive and family planning services, with references to current national guidelines (September 2019).
DMPA SQ and Self-Administration Procedures Clinical Protocol Template
Supports creation of organization-specific protocols for offering DMPA SQ to patients for self-administration — reducing the need for in-person visits — and provides a blueprint for other clinical protocols (October 2020).
Sample Policy & Procedure: Development, Review, and Maintenance of Organizational Policies and Procedures
A sample policy and procedure for documenting the process for developing, reviewing, and maintaining internal policies and procedures (January 2019).
Sample Policy & Procedure: Training and Implementation Guidelines for Policy and Procedure Changes
A sample policy and procedure to ensure staff are appropriately trained on policies and that sufficient documentation demonstrates training was completed and transfer of knowledge occurred (January 2019).
Sample Policy & Procedure: Archiving Policies and Procedures
A sample policy and procedure for clarifying document retention and archival practices (January 2019).
Opening & Closing Health Center Sites
Quality Designations

Patient-centered, coordinated care remains a fundamental component of the 2024 QFP recommendations and standards for high-quality care. Quality recognition and value-based care programs provide health care organizations with frameworks to strengthen clinical quality, patient experience, health equity, and care coordination. These programs facilitate the use of data, performance measurement, and continuous quality improvement strategies to improve care over time, while also offering external validation of providers' commitment to high standards of care.

NFPRHA's Work: NFPRHA supports its members in creating sustainable business models while maintaining their mission to provide high-quality family planning and sexual health services to predominantly low-income and underinsured individuals. Quality designation programs — like the National Committee of Quality Assurance (NCQA) Patient-Centered Specialty Practice (PCSP) or Patient-Centered Medical Home (PCMH) recognition programs — offer family planning providers frameworks to strengthen quality improvement efforts, person-centered care, and long-term sustainability. These programs can also help position providers to participate in value-based payment and other alternative payment models that increasingly emphasize access, patient experience, care coordination, and health equity. NFPRHA views these designations as an opportunity for family planning providers to demonstrate their commitment to high-quality, accessible, and equitable care.

Workforce

The family planning network depends on a strong, well-supported public health workforce to provide high-quality, equitable care. In recent years, providers have faced growing workforce challenges — including shortages, burnout, increased administrative burdens, and persistent barriers to recruitment and retention, particularly in underserved and rural communities. At the same time, demand for family planning and sexual health services continues to grow amid ongoing threats to reproductive health access and widening health inequities.

Publicly funded family planning providers must be supported in implementing innovative workforce strategies, including expanding training opportunities, strengthening provider pathways, investing in culturally responsive care, and improving compensation and workplace supports. Efforts should also prioritize recruiting and retaining providers who reflect and are rooted in the communities they serve, helping to strengthen trust, improve patient experiences, and advance health equity.

NFPRHA's Work: NFPRHA led the fight to make family planning providers eligible to receive clinicians through the National Health Service Corps (NHSC) under the ACA — a federal program that provides loans, scholarships, and other funding to clinicians who commit to working in medically underserved areas across the US. NFPRHA is also helping its members advocate for changes to state clinical licensing and scope-of-practice laws that have the potential to expand the care that mid-level clinicians — including nurse practitioners, physician assistants, and certified nurse midwives — can provide, adding capacity to many family planning centers.

NFPRHA Case Studies
Other Resources
Sexuality Education

NFPRHA believes that all people should have access to high-quality, comprehensive, and medically accurate sexuality education that is applicable for LGBTQIA+ people and uplifts sexual freedom as a normal human experience. Sexuality education should include — at developmentally appropriate levels of detail — information about sexual development throughout the lifetime; sexual orientation, gender identity, and expression; achieving and preventing pregnancy; STI and HIV prevention and treatment; pregnancy options; healthy relationships; and sexual violence including the importance of affirmative consent.

NFPRHA recognizes the need for sexuality education to extend beyond the classroom and continue across the lifespan. Family planning and sexual health providers champion sexuality education and have an important role in its delivery to people of all ages. Parental or trusted adult involvement may be encouraged but should never be required — providers must be able to discuss family planning and sexual health information with patients confidentially and without restriction.

NFPRHA supports continued federal funding for high-quality, comprehensive, and medically accurate sexuality education, and urges investments in research to improve existing federal initiatives and expand sustainable programming in clinical and community-based settings.

Improving Access and Quality for All
NFPRHA's resource guide and assessment tool to assist family planning providers in identifying work needed within their agency to address systemic barriers to care and improve access to high-quality health care. By applying this tool, health care organizations can strengthen efforts to improve sexual and reproductive health outcomes.
Supporting Adolescents & Young Adults
Teen Pregnancy Prevention Program (TPPP)
NFPRHA supports funding for TPPP, first funded through the Consolidated Appropriations Act of 2010. All TPPP-funded projects must be medically accurate. In 2025, five Planned Parenthood affiliates filed a lawsuit against the Trump administration to protect TPPP against vague, last-minute requirements issued by HHS requiring grantees to demonstrate alignment with Executive Orders on DEI and LGBTQIA+ materials. A US District Judge blocked enforcement of those policies, ruling they violate the Administrative Procedure Act.
Personal Responsibility Education Program (PREP)
Created by the ACA in 2010, PREP provides $75 million annually to states for comprehensive, medically accurate, age-appropriate sexuality education to prevent unintended pregnancy and STDs including HIV/AIDS. PREP programs are also required to address life skills that help teens make responsible decisions.
Abstinence-Only Programs
Since 1996, the US has spent more than $2.1 billion in federal funds on abstinence-only programs — sometimes referred to as AOUM or SRAE — that harm young people and do nothing to prevent unintended pregnancies or STDs. NFPRHA opposes abstinence-only efforts and advocates for their elimination from federal spending bills, including opposing continuation of the Title V Sexual Risk Avoidance Education program.
Key Organizations & Resources

More NFPRHA Resources

For additional fact sheets, federal comments, and publications organized by issue, visit NFPRHA fact sheets, the federal comments archive, or browse NFPRHA's publications and recent press statements.