Colorectal Cancer Screening Project | 2023-11

Pdf Summary

This document discusses efforts made by a primary care practice to improve completion rates of screening after a positive stool-based test. The practice initially had a screening rate of 57.5% and implemented strategies such as offering choice in screening and transparent provider reporting to increase screening rates to over 80%. They also focused on increasing the completion of colonoscopy after a positive stool-based test.<br /><br />In March 2013, 57.5% of patients with a positive fecal immunochemical test (FIT) completed a colonoscopy. The practice developed provider and staff messaging, created a registry for positive FITs, and sent personalized letters to procrastinators. These initiatives resulted in an 88.7% completion rate of colonoscopies.<br /><br />The average time between a positive FIT and a diagnostic colonoscopy was 41 days. The document also mentions the impact of the COVID-19 pandemic on screening performance. From January 2020 to September 2021, 55.5% of patients with a positive FIT completed a colonoscopy, but with continued efforts, this increased to 79.1% by September 2022.<br /><br />The document highlights the retirement of a productive gastroenterologist, a growth in new patients, the addition of a 45-49 age cohort, and planning for a collaborative effort with the AMGA CRC screening initiative as significant events from 2021 to 2023.<br /><br />Insights from quarters in 2022 and 2023 show varying percentages of colonoscopies completed within 90 and 180 days of a positive stool-based test. The practice emphasizes plans to energize primary care providers, mentor advanced practice clinicians, collaborate with the parent organization's gastroenterology department, implement direct scheduling of colonoscopies, and prioritize colonoscopy scheduling for patients with positive stool-based tests. The practice has also transitioned to using the Epic electronic health record system.

Asset Subtitle

Francis Colangelo, MD

Keywords

primary care practice

screening completion rates

stool-based test

choice in screening

transparent provider reporting

colonoscopy completion

positive FIT

COVID-19 pandemic

retirement of gastroenterologist

AMGA CRC screening initiative