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The challenge: How do you get women to come in for reproductive health care when their days are filled with multiple roles as student, mother, employee, or two-job employee? The solution: Offer a late-night clinic at your facility.
Planned Parenthood of Houston and South east Texas kicked off a test night clinic at the beginning of the year. Results of an informal survey among Planned Parenthood affiliates indicate that the Houston facility is the first to offer such a service, according to Planned Parenthood-Houston spokeswoman Susan Nenney.
The test program is in the process of review as of Contraceptive Technology Update press time, but clinic director and clinician Marie Tekle, RNC, WHC, CNP, hopes it will get the green light from administration to continue its twice-a-month schedule. "I think times have changed," says Tekle, a 25-year Planned Parenthood veteran. "We have to meet the needs of the consumer now."
The Houston Planned Parenthood program already offers a wide variety of operating hours. It opens every day at 7 a.m. during the week and even offers Saturday service. Still, many women would tell Tekle, "you just don’t have hours for me," when she asked them about their care.
Whether they were college students with after-class jobs, women holding down two jobs, or women with night-shift employment, all shared a common problem: an inability to get to the clinic during daytime hours. Tekle drew up the plans for the pilot night clinic, received administration clearance, and began the first one Jan. 15.
Tekle says Friday nights work best because most people who work are off on Saturdays. The night clinic, under its test formation, is held twice a month on Friday. It began with hours of 10:30 p.m. to 7 a.m. but has operated the last two months from 7:30 p.m. to 3:30 a.m.
By modifying the hours during the test phase of the clinic, program administrators have been able to see what works best for the patients. Initial findings show that most women prefer to come in from 7:30 p.m. to 1:30 a.m.
The night clinic offers the identical services that are available during the daytime, reports Tekle. "We have inserted IUDs, we have done pregnancy confirmations, we have supplied birth control — just whatever we do during the day."
Publicizing the clinic has been very low-key: Other than an announcement on the facility’s recorded telephone greeting and a few scattered posters around the building, news of the night clinic has been mainly by word of mouth. This has allowed the clinic to evolve without fear of protest, since reproductive health facilities are often the site of anti-abortion picketers. While there have been no problems since the service has been in operation, a security guard is on staff, says Tekle. If the night clinic receives approval as a ongoing venture, it will be marketed more aggressively, she notes.
Patients, providers win
The night clinic is staffed by one clinician and two clinician assistants. A night’s schedule may include around 25 patients, with an average of 17 to 22 coming in for their appointments.
The clinic offers benefits for both patients and providers. Patients tend to keep their appointments better at night, and those who work in the clinic say patients are much calmer. Women who use the clinic’s services say they don’t have to wait as long, and the night hours cut the number of children who often have to accompany women during the daytime due to lack of childcare. Park ing, which can be a problem during the daytime, is more easily accessed at night.
Staff who work the night clinic like the scheduling flexibility afforded by the service, since they trade a day shift for a night shift. The convenience of having an off-day during the week is an attractive option, reports Tekle.
The night clinic costs the same to run as a day clinic; in fact, the service has shown a profit, she notes. Perhaps the most important benefit is the fact that patients’ needs are being met at a time when time constraints are pulling women in many different directions.
"Many of the patients, especially those who are working two jobs or have problems with transportation, say Please keep this up — don’t stop it,’" says Tekle.
Nenney agrees. "The night clinic is meeting a huge need," she says. "Access is critical, especially when it comes to women’s health care."