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Increasing colorectal cancer screening orders using unlicensed assistive personnel

BACKGROUND: Colorectal cancer (CRC) is among the leading cancer diagnoses affecting both men and women worldwide. Prevention and early detection of CRC is possible by increasing access to and utilisation of screening tests. Although CRC screening is highly recommended, screening rates remain subopti...

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Autores principales: Ishida, Kanako, Weiss, Erin, Kee, Summer A, Yingling, Charles T
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6606072/
https://www.ncbi.nlm.nih.gov/pubmed/31321316
http://dx.doi.org/10.1136/bmjoq-2018-000545
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author Ishida, Kanako
Weiss, Erin
Kee, Summer A
Yingling, Charles T
author_facet Ishida, Kanako
Weiss, Erin
Kee, Summer A
Yingling, Charles T
author_sort Ishida, Kanako
collection PubMed
description BACKGROUND: Colorectal cancer (CRC) is among the leading cancer diagnoses affecting both men and women worldwide. Prevention and early detection of CRC is possible by increasing access to and utilisation of screening tests. Although CRC screening is highly recommended, screening rates remain suboptimal in the USA, particularly among underserved populations. Our project site, an urban federally qualified health centre, was not meeting the national screening target of 80% of eligible adults. OBJECTIVE: The aim of this quality improvement project was to increase the number of orders for CRC screening to eligible patients by using unlicensed assistive personnel and automated telephone outreach calls to offer 100 patients CRC screening during an 8-week period. METHODS: 40 patients received outreach calls from care coordinators (CC). 40 patients received automated telephone call reminders to call a CC to obtain an order for CRC screening. 20 patients were offered CRC screening by a medical assistant (MA) as part of their scheduled office visits. We used two plan-do-study-act (PDSA) cycles to deliver these three screening interventions. RESULTS: A total of 100 patients received one of the interventions. Ten of those patients received an order for either colonoscopy or faecal immunochemical testing by the conclusion of the second PDSA cycle. The MA-offered screening resulted in the highest percentage of patients accepting CRC screenings and patients preferred this outreach approach compared with CC outreach or automated voice messages. CC outreach yielded a lower rate of accepted screenings. None of the patients who received the automated calls followed up to obtain a screening order. CONCLUSION: Our project demonstrates that unlicensed assistive personnel have the potential to increase patient access to CRC screening.
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spelling pubmed-66060722019-07-18 Increasing colorectal cancer screening orders using unlicensed assistive personnel Ishida, Kanako Weiss, Erin Kee, Summer A Yingling, Charles T BMJ Open Qual BMJ Quality Improvement report BACKGROUND: Colorectal cancer (CRC) is among the leading cancer diagnoses affecting both men and women worldwide. Prevention and early detection of CRC is possible by increasing access to and utilisation of screening tests. Although CRC screening is highly recommended, screening rates remain suboptimal in the USA, particularly among underserved populations. Our project site, an urban federally qualified health centre, was not meeting the national screening target of 80% of eligible adults. OBJECTIVE: The aim of this quality improvement project was to increase the number of orders for CRC screening to eligible patients by using unlicensed assistive personnel and automated telephone outreach calls to offer 100 patients CRC screening during an 8-week period. METHODS: 40 patients received outreach calls from care coordinators (CC). 40 patients received automated telephone call reminders to call a CC to obtain an order for CRC screening. 20 patients were offered CRC screening by a medical assistant (MA) as part of their scheduled office visits. We used two plan-do-study-act (PDSA) cycles to deliver these three screening interventions. RESULTS: A total of 100 patients received one of the interventions. Ten of those patients received an order for either colonoscopy or faecal immunochemical testing by the conclusion of the second PDSA cycle. The MA-offered screening resulted in the highest percentage of patients accepting CRC screenings and patients preferred this outreach approach compared with CC outreach or automated voice messages. CC outreach yielded a lower rate of accepted screenings. None of the patients who received the automated calls followed up to obtain a screening order. CONCLUSION: Our project demonstrates that unlicensed assistive personnel have the potential to increase patient access to CRC screening. BMJ Publishing Group 2019-06-29 /pmc/articles/PMC6606072/ /pubmed/31321316 http://dx.doi.org/10.1136/bmjoq-2018-000545 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle BMJ Quality Improvement report
Ishida, Kanako
Weiss, Erin
Kee, Summer A
Yingling, Charles T
Increasing colorectal cancer screening orders using unlicensed assistive personnel
title Increasing colorectal cancer screening orders using unlicensed assistive personnel
title_full Increasing colorectal cancer screening orders using unlicensed assistive personnel
title_fullStr Increasing colorectal cancer screening orders using unlicensed assistive personnel
title_full_unstemmed Increasing colorectal cancer screening orders using unlicensed assistive personnel
title_short Increasing colorectal cancer screening orders using unlicensed assistive personnel
title_sort increasing colorectal cancer screening orders using unlicensed assistive personnel
topic BMJ Quality Improvement report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6606072/
https://www.ncbi.nlm.nih.gov/pubmed/31321316
http://dx.doi.org/10.1136/bmjoq-2018-000545
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