Health Quality Ontario’s Heavy Menstrual Bleeding Quality Standard addresses
care for people of reproductive age who have heavy menstrual bleeding,
regardless of the underlying cause. The quality standard includes both acute
and chronic heavy menstrual bleeding, and applies to all care settings. It does
not apply to people with non-menstrual bleeding or with heavy menstrual
bleeding occurring within 3 months of a pregnancy, miscarriage, or abortion.
The quality standard includes 14 quality statements addressing areas that have high
potential for improving the quality of care in Ontario for people with heavy
menstrual bleeding.
Below is a sample of tools that may help you with the
implementation of the quality statements into practice, organized according to
purpose. Several of these tools will help to support multiple quality
statements.
Are there other tools or resources you use? Do you have
experience implementing these tools? If you have feedback about any of
these tools, please use the comments section below to share!
Comprehensive Tools and Resources
- NICE Pathway: Heavy Menstrual Bleeding Overview—an
interactive flowchart by the National Institute for Health and
Care Excellence that provides detailed
recommendations for the diagnosis, assessment, and
management of heavy menstrual bleeding
Tools to Support Clinical Practice
- HMB: A National Audit—a tool by the Royal College
of Obstetricians and Gynaecologists that includes
comprehensive questions for assessing symptoms and health-related
quality of life among people with heavy menstrual
bleeding (HMB). (Note: The demographic questions on
page 8 of this document are not suitable for the Canadian
context)
- Self-Administered
Bleeding Assessment Tool (Self-BAT)
—a scientifically validated scoring tool
developed by Dr. Paula James of Queen’s University to
help identify bleeding disorders that cause heavy menstrual
bleeding
- Iron Deficiency: Diagnosis and Management Guidelines—clinical
practice guidelines from the British Columbia Guidelines and Protocol
Advisory Committee that provide recommendations for the diagnosis,
investigation and management of iron deficiency in patients of all ages,
including those with anemia due to heavy menstrual bleeding
Shared Decision-Making Aids
- Shared Decision Making Aid for Heavy Menstrual Bleeding—a
tool endorsed by the National Institute for Health and Care
Excellence to help health care professionals and patients work together
to review the treatment options for heavy menstrual bleeding, weigh the
benefits and risks of each option, and make a decision that is best for the
patient. (Note: This tool is from the United Kingdom; different
oral progestins are used in Canada.)
- Menstrual Journal—a paper-based tool recommended by The
Society of Obstetricians and Gynaecologists of Canada to help
determine the root cause of a person’s heavy menstrual bleeding by
auditing menstrual flow, medications taken, symptoms experienced, and other
impacts on life
- Uterine Fibroids: Should I Have Uterine Fibroid Embolization?—a tool available
through HealthLinkBC to help patients (whose heavy
menstrual bleeding is caused by uterine fibroids) decide if uterine
fibroid embolization is right for them
Resources for Patients and Families
Other Tools and Resources
Comment below to describe your experience with these
tools or share any others you have found useful!