With colorectal cancer, CRC, screening rates of 32% in 2013, quality improvement, QI, leaders at St. George Medical Clinic made a commitment in 2014 to improving this important preventive health measure. That commitment and the subsequent focus of the health center staff resulted in an almost doubling of the CRC screening rate to 61% in the 2014 UDS report.
Improvement work on CRC screening included several different projects during the year. Beginning in the spring of 2014, a team from St. George participated in the WVPCA webinar series, Using Data for Quality Improvement. During this 6 month project taught by representatives from OCHIN, the team learned about the Model for Improvement, including Plan Do Study Act Cycles and run charts. This worked led to their regular use of reports to measure progress as they worked on processes to improve rates of CRC screening.
During the summer, St. George took advantage of an outreach effort by the American Cancer Society, ACS, to promote the FLU/FIT program, which offers patients receiving flu vaccinations a chance to learn more about CRC screening recommendations. The FLU/FIT program is evidence based and has been shown to be effective in community health centers, but had not been promoted in West Virginia previously. ACS representatives worked with the staff to implement the program according to guidelines. An important first step was getting input from staff on how to incorporate the initiative into the busy clinic day. They decided as a team how to promote the screening, what the plans for follow up would be, and how to document results so the work was captured accurately.
During the FLU/FIT initiative, home fecal immunochemical (FIT) kits were given out to patients who came in for a flu vaccine, if the patient was between the ages of 50 to 74. Both nurses and providers educated patients about the importance of CRC screening. Nurses also made follow up calls to ensure the kits were completed. The staff found that patients were more receptive to the FIT test than to other home FOBT kits or to colonoscopy. All positive tests were referred for colonoscopy.
Other efforts to raise rates included a patient education campaign with notices in the local newspaper and reminder calls to patients identified through EHR reports. The ACS also provided patient education materials to St. George’s clinical staff for use in the exam room and waiting room.
St. George Medical Clinic is reviewing the success of last year’s work on CRC and looking for ways to raise the screening rate again in 2015. They are also working with staff to apply the experiences in CRC screening to other cancer measures such as cervical and breast cancer screening. Staff from St. George will be attending a May workshop hosted by the WVPCA to share their strategies, and work with other centers sharing ‘current practices’ in CRC screening improvement. Please stay tuned to future WVPCA e-news for details.
Congratulations to the staff at St. George Medical Clinic for their dedication in improving the detection of colon cancer in their community!
