SUCCESSFUL INTERVENTIONS TO INCREASE COLON CANCER SCREENING RATES IN A SINGLE URBAN-BASED ENDOSCOPY UNIVERSITY CENTER;A QUALITY IMPROVEMENT PROJECT

ABSTRACT

Background: Colorectal cancer (CRC) screening is essential in preventive care (1, 2, 3). Societies, such as the American College of Gastroenterology (ACG) and the National Colorectal Cancer Roundtable (NCCRT), have a goal of reaching colorectal cancer screening rates of 80 % per community (4, 5). The screening rate in our clinic was 42.8 % in 2019;however, the majority of the residents were only offering invasive measures;such as colonoscopy. We aimed to improve the CRC screening rate by multiple modalities including;reeducating residents, implementing changes to the electronic medical record, and scheduling patients for wellness/preventative care visits to increase the colon cancer screening rate. Methods: Multiple methods were used as follows;An initial questionnaire to inquire about the CRC screening options given by the residents to the patient, then a didactic lecture to further explain different options, and a follow-up lecture in the clinic. Also, The Electronic medical record was adjusted to have a particular notification tab and preventive care options if the patient qualifies for CRC screening. The percent change, percent difference and the absolute difference were used to analyze the results. The Institutional Review Board approved this study. Results: CRC screening rates increased from 42.8% in 2019 to 67.4% in July 2020 with an absolute difference of 24.6, a percent difference of 44.65 %, and a percent change of 57.48 % (Figure 1). Discussion: Colonoscopy remains the gold standard for CRC screening;however other modalities are also approved including;stool testing and virtual colonoscopies (1, 2, 3, 6). Multiple societies in the United States have set a goal to reach 80% screening per community (4, 5). In 2019, the screening rate at our institution was 42.8 %. After noticing this, we decided to conduct this QI project to improve our screening rates. Our experience focused on a survey-based approach, mainly on assessing what residents offer for colon cancer screening, especially when the patients refuse colonoscopy as a form of screening (3). Residents were educated in their regular didactic sessions and with small seminars during their continuity clinic. Patient visits were also changed and focused on scheduling patients during regular wellness/preventative health care visits. Screening rates showed an absolute difference increase of 24.6 despite being affected by the COVID pandemic. We anticipate further increase in the following years and hopefully, we will reach the 80% screening goal of ACG and NCCRT (4, 5). Conclusions: Interventions that address root cause analysis and education continue to be the answer to most of our questions.(Figure Presented)