Featured Articles: Quality Improvement

How to Improve Colorectal Cancer Screening Rate

Wednesday, July 13, 2016   (0 Comments)
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Adam Richins, Family Health Services


Many people may not be aware that colorectal cancer is the third leading cause of cancer death in both men and women in the United States.  In an effort to move the Healthy People Initiative forward, Family Health Services (FHS) has recognized the national goal of colorectal cancer screening of 70.5% by 2020, and the Idaho state goal of 80% by 2018.

Starting at age 50, both men and women should receive colorectal cancer screening. Screening at age 40 or sooner may be recommended based on family history of the disease.  Screening tests can detect polyps so that they can be removed before they turn into cancer. With early testing, cancer can be detected in its beginning stages when cure rates with treatment are highest. Unfortunately, many Americans are not getting the recommended cancer screenings.

Within our organization, we recognized that large portions of our patients were not being screened. In 2015, when our colorectal cancer screening percentages were evaluated, our organization as a whole was at 18%. With this being the case, a new workflow and focus was pursued by FHS. With this focus came a change in work flows, outreach, and provider discussions.

Outreach was started with an automated call back system to those patients who fell within screening age ranges. Outreach was also performed by medial providers and nursing staff who identified patients for colorectal cancer screening on a daily huddle form. Post cards were also mailed to the identified screening population.

While a colonoscopy remains the gold standard for screening, it is often unobtainable for many due to cost. Many publications have encouraged guaiac-based or immunochemical fecal occult testing (FIT). Upon review, FHS decided to implement increased screening efforts with FIT testing and colonoscopies when possible.

With initial low screening rates, an increased focus and change was placed on workflows and identifying patients who lacked screening. Once patients were identified while at the clinic for an appointment or via outreach, the patient was invited to participate in preventative health and the FIT test process was explained to them. The patient was given the FIT card, and invited to return the card. Reminder calls from nursing staff also took place to those who failed to return their cards in a timely manner.

During the month of March, national colorectal cancer screening month, there was an increased awareness within the organization and tests were discounted for patients. Social media alerts and signage in the clinics was also used to promote screening. Due to this increased attention, the screening rates for 2016 within our organization are currently 43.8%.  All clinics improved their screening rates, with one clinic improving by 21%.  Overall, screening rates have greatly improved. However, most importantly, patients have received preventative care and any abnormalities identified.

Contact Adam Richins at Family Health Services with any questions.



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