Successful implementation of One Key Question requires incorporating the question into routine patient assessment. The LA County Department of Public Health recommends including the question in an initial visit, and then, at minimum, annually or whenever a new medication is prescribed. It is important to have a protocol for a given clinical setting to ensure that the question is consistently asked of patients and that the process is straightforward for the clinician, clinic staff, and the patient.4 The question need not be posed by the clinician but can be asked by a medical assistant, nurse, or other members of the health care team. This could occur while taking a history, checking vital signs, or once the patient is roomed—anywhere that privacy can be assured. The question can be automated and flagged in the electronic health record, so that a member of the team can review the response during the visit and that a qualified health professional provides the necessary follow up.
Support for One Key Question
The consensus that One Key Question is an important tool is growing. One Key Question has been endorsed by 30 public health and professional organizations including the American College of Obstetrics and Gynecology, the American Public Health Association, Physicians for Reproductive Health, and the National Association of Nurse Practitioners in Women’s Health. The American Academy of Family Physicians recommends that a woman’s reproductive life plan be discussed at each visit.9
One Key Question provides a straightforward screening tool for engaging patients in a critical conversation about improving health and well-being prior to pregnancy and preventing unintended pregnancies. The Department of Public Health is promoting One Key Question as a strategy to advance women’s health. Because One Key Question serves as a means both to promote equity and to empower women of color, it has been incorporated into our multi-pronged approach to reduce African American Infant Mortality by 2023.10
The implementation of preventive reproductive health care is essential for many women of childbearing age. By taking a nonjudgmental but proactive approach to women’s reproductive aims, providers can build trust that is a precondition for effective treatment and for a rewarding doctor-patient relationship. Because primary care providers play a fundamental role in meeting the comprehensive health needs of women with childbearing potential, LA County Department of Public Health hopes providers will implement this approach into their practice.