Department: Primary Care Team B, North Lancaster Medical Offices (Northwest)
Value Compass: Quality
SMART goal: Improve the rate of return for Fecal Immunochemical Tests (FIT) kits from 72.7 percent in January 2011 to 74.9 percent by the end of Q4 2012
Metric: Percent of eligible patients who have completed the annual colorectal cancer screening test as documented on the monthly HEDIS report
Labor co-lead: Bill Waters, medical assistant, SEIU Local 49
Management co-lead: Phillip Taylor, department administrator, Primary Care
Small tests of change:
- Identify members who are eligible for colorectal screening
- Develop scripting to personalize the importance of the screening
- Create a process for follow up with members
Result: The team exceeded its target, hitting an 81.7 percent rate of return in December 2012
When the North Lancaster Primary Care Team B unit-based team decided to work on improving colorectal screening rates, it adapted what colleagues at the West Salem Medical Office were doing and developed an approach that included a two-pronged outreach system and a plan for ensuring team members were delivering a consistent message.
“Our patients are not a number or a statistic, they are a person, and they are looking for us to take care of them,” says Taylor, who was the team’s co-lead at the time the project was under way.
The scripting the team members delivered made the importance of the test personal: They told the story of how physicians in the clinic had tested positive—but because the disease was detected early, they got treatment in time and are doing well.
In addition, the team identified its eligible patients between the ages of 50 and 75. When one of those patients came into the clinic, the medical assistant would talk about the importance of the test and give him or her the FIT kit to take home and return via mail.
When the physician saw the patient, the physician would reiterate the need to do the test.
Nurses would track the distribution of the kits and follow up with the patient if the kit had not been returned. When they reached out to the patient, they would mention that the physician was looking for the FIT kit and that it was very important for them to get it returned.
The combination of methods worked even better than hoped: The team shot past its target by nearly 7 percentage points.
“We’re looking for early detection,” says labor co-lead Waters. “Colorectal cancer can hit anybody, and we explain how it’s impacted our own providers at our clinic. We add a personal touch by telling our story, and people respond.”
The North Lancaster Medical Office Lab was selected as the only unit-based team in the region to attend the Institute for Healthcare Improvement conference in December.