Improving the completion rate of outpatient stool-based colon cancer screening during a global pandemic.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 238-238
Author(s):  
Ye Aung ◽  
Christian Scherer ◽  
Andrew Gdowski ◽  
Doris Cubas ◽  
Alexandra Horton ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Cancer Screening ◽  
Colon Cancer Screening ◽  
Return Rate ◽  
Professional Communication ◽  
Screening Tests ◽  
Screening Process ◽  
Return Rates ◽  
Root Cause ◽  
Global Pandemic

238 Background: Colon Cancer Screening is an important intervention to reduce the morbidity and mortality of colorectal cancer. In particular, stool based screening tests help to increase the availability of screening especially amidst a global pandemic. However stool based screening is limited by patient return rates of FIT/iFOBT tests. Here at the Austin Outpatient VA we sought to improve the FIT test return rate of patients in our resident clinic by at least 20%. Methods: We did a root cause analysis as to why iFOBT/FIT were not being returned, particularly during the height of the pandemic when most visits were virtual. With help from the VA data core we generated a list of 76 patients during a period from 2/3/2020-7/7/2020 who had not returned an ordered FIT/iFOBT test in >30 days. We called these patients to identify the reasons why they did not return their test. Results: We were able to reach (44/76) patients and discovered that only (12/44) 27.3% of patients contacted had received a FIT test. Of our patients-reached 33/44 of them asked for a new FIT test to be sent to them and ultimately (21/44) patients contacted returned and completed their FIT test successfully with 3 tests being positive and referred to diagnostic colonoscopy. This resulted in an improvement in return rate of ̃47% of all patients ultimately contacted. Conclusions: Through a meeting of stakeholders including nurses and resident physicians we discovered in our EMR, that the order to send out a FIT test does not automatically alert a nurse nor does it automatically mail out or send out a FIT test. We discovered there was not a standardized process in place to facilitate communication between physicians ordering tests and nurses, thus FIT/FOBT tests were not being sent. We are currently working on a process to standardize the FIT test ordering process to improve communication between physicians and nurses. We are developing a better order set that reminds providers to alert and message nurses prior to ordering the FIT/iFOBT test. We are also educating Residents about the FIT/FOBT ordering process. With future PDSA cycles we should be able to improve the robustness and reliability of our outpatient colon cancer screening process through improved inter-professional communication.

scholarly journals Layperson Views about the Design and Evaluation of Decision Aids: A Public Deliberation

2021 ◽  
pp. 0272989X2199898
Author(s):  
Peter H. Schwartz ◽  
Kieran C. O’Doherty ◽  
Colene Bentley ◽  
Karen K. Schmidt ◽  
Michael M. Burgess
Keyword(s):  
Colon Cancer ◽  
Cancer Screening ◽  
Decision Aid ◽  
Decision Aids ◽  
Risk Information ◽  
Colon Cancer Screening ◽  
Public Deliberation ◽  
Screening Tests ◽  
Medical Decision ◽  
Baseline Risk

Purpose We carried out the first public deliberation to elicit lay input regarding guidelines for the design and evaluation of decision aids, focusing on the example of colorectal (“colon”) cancer screening. Methods A random, demographically stratified sample of 28 laypeople convened for 4 days, during which they were informed about key issues regarding colon cancer, screening tests, risk communication, and decision aids. Participants then deliberated in small and large group sessions about the following: 1) What information should be included in all decision aids for colon screening? 2) What risk information should be in a decision aid and how should risk information be presented? 3) What makes a screening decision a good one (reasonable or legitimate)? 4) What makes a decision aid and the advice it provides trustworthy? With the help of a trained facilitator, the deliberants formulated recommendations, and a vote was held on each to identify support and alternative views. Results Twenty-one recommendations (“deliberative conclusions”) were strongly supported. Some conclusions matched current recommendations, such as that decision aids should be available for use with and without providers present (conclusions 1–4) and should support informed choice (conclusion 9). Some conclusions differed from current recommendations, at least in emphasis—for example, that decision aids should disclose cost of screening (conclusion 11) and should be kept simple and understandable (conclusion 14). Deliberants recommended that decision aids should disclose the baseline risk of getting colon cancer (conclusions 15, 17). Limitations Single location and medical decision. Conclusions Guidelines for design of decision aids should consider putting a greater focus on disclosing cost and keeping decision aids simple, and they possibly should recommend disclosing less extensive amounts of quantitative information than currently recommended.

Patient Preferences for Colon Cancer Screening Tests

2009 ◽  
Vol 69 (5) ◽  
pp. AB312
Author(s):  
Danielle Bender ◽  
Avlin B. Imaeda ◽  
Liana Fraenkel
Keyword(s):  
Colon Cancer ◽  
Cancer Screening ◽  
Patient Preferences ◽  
Colon Cancer Screening ◽  
Screening Tests ◽  
Cancer Screening Tests

scholarly journals The Relationship Between Technology Use and Colon Cancer Screening

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 317-317
Author(s):  
Na Sun
Keyword(s):  
Colon Cancer ◽  
Cancer Screening ◽  
Health Care Providers ◽  
Technology Use ◽  
Mobile Apps ◽  
College Education ◽  
Colon Cancer Screening ◽  
Screening Tests ◽  
Care Providers ◽  
The Relationship

Abstract Population aging is accompanied by an increase in chronic diseases such as cancer. Colon cancer is the third most common cancer and a leading cause of cancer death. Screening tests can aid early detection and treatment. It is unclear how information and communication technology (ICT), especially media through mobile devices, influences cancer screening. This study analyzes the relationship between ICT usage and colon cancer screening among U.S. adults. Data are from the second cycle of the Health Information National Trend Survey 5. Cancer screening included having one of the following: colonoscopy, sigmoidoscopy and/or stool blood test to check for colon cancer. Approximately 70% of respondents had at least some college education, 51% were female, and the mean age was 48 years. More than half of respondents report using apps on a tablet or smartphone for health and wellness purposes, and around 70% of them used apps for health communication and decision-making. Based on results of a binary logistic regression model, people who use mobile apps for discussions with health care providers (p<0.01), who use the internet to look for information about cancer (p <0.01), and who do not use mobile apps to make decisions about how to treat an illness or condition (p<0.01) are more likely to conduct cancer screening. ICT usage may enable people to gather information about cancer screening and improve patient and physician communication. Future studies should explore longitudinal associations between ICT usage, cancer screening, and cancer outcomes.

scholarly journals Subject Preference for Blood vs Fecal Sample in Colon Cancer Screening Tests

2011 ◽  
Vol 140 (5) ◽  
pp. S-420
Author(s):  
Joanne M. Lane ◽  
Carlene Wilson ◽  
Vivienne Moore ◽  
Tess Gregory ◽  
Graeme P. Young
Keyword(s):  
Colon Cancer ◽  
Cancer Screening ◽  
Fecal Sample ◽  
Colon Cancer Screening ◽  
Screening Tests ◽  
Cancer Screening Tests

Predictors of colon cancer screening among low-income urban minority residents: The Cancer Risk Assessment in Baltimore (CRAB) Study

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 4101-4101
Author(s):  
R. A. Mentor-Marcel ◽  
K. Visvanathan ◽  
M. A. Garza ◽  
Y. Xie ◽  
L. McCaffrey ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Colon Cancer ◽  
Cancer Screening ◽  
Low Income ◽  
College Education ◽  
Primary Care Providers ◽  
Colon Cancer Screening ◽  
Screening Tests ◽  
Health Care Coverage

4101 Background: Colorectal cancer mortality can be reduced through early detection, using recommended screening tests (fecal occult blood test (FOBT), sigmoidoscopy, or colonoscopy). However, screening is underutilized, especially among low-income and racial/ethnic minority groups. Few studies have examined determinants of screening in these groups. Methods: We analyzed data on predictors of colon cancer screening from a cross-sectional study of Baltimore City Residents (N = 534). Participants responded to a questionnaire administered by an interviewer, on screening practices, behavioral, social and demographic factors, including income level. Eligible respondents for this analysis were age = 50, aware of colorectal screening tests, but not diagnosed with colon polyps or cancer. Multivariate techniques were used to examine predictors of having undergone any recommended colon cancer screening test. Results: The eligible population for this analysis (N=202) was 49.0 % male and 51.0 % female. The median income fell within the $12,000-$24,999 bracket. The proportion of participants that had received colon cancer screening was 34.5 % among those in the highest income bracket (i.e. =$25,000) compared to 30.0 % in the lowest income bracket (i.e. =$11,999). This difference was statistically significant after adjusting for other sociodemographic factors (odds ratio (OR)=3.12, p=0.023). Multivariate analysis indicated that screening was associated with having one (OR: 3.56, p=0.016) or more than one (OR: 7.31, p=0.006) primary health care provider. Having health care coverage, a doctor who recommended exercise, and having at least some college education, were also associated with screening. Conclusions: Negative predictors of colorectal cancer screening include: extremely low income levels (= $11,999), lack of health care coverage, primary care providers, and college education level. Provider recommendations for healthy behaviors (e.g. exercise) are associated with patient adherence to recommended cancer screenings. The design of interventions to promote use of screening tests by low-income populations should be informed by the substantial heterogeneity in patient and provider characteristics within these populations. No significant financial relationships to disclose.

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