AIM Statement: 
Our aim at Wednesday JHAP was to increase the rate of colorectal cancer screenings from 44.3% to 60% from September 2016 to May 2017 (9 months)https://jdc.jefferson.edu/patientsafetyposters/1032/thumbnail.jp

Lee, MD, Albert

Mei, MD, Newton

Shah, MD, Mital

Yang, MD, Grace

English

AIM Statement: 
Our aim at Wednesday JHAP was to increase the rate of colorectal cancer screenings from 44.3% to 60% from September 2016 to May 2017 (9 months)http://jdc.jefferson.edu/patientsafetyposters/1032/thumbnail.jp

Name not available

Improving Colon Cancer Screening in a Resident Ambulatory Clinic

Jefferson Digital Commons

Thomas Jefferson UniversityJefferson Digital CommonsHouse Staff Quality Improvement and PatientSafety Posters GME Quality and Safety5-31-2017Improving Colon Cancer Screening in a ResidentAmbulatory ClinicNewton Mei, MDThomas Jefferson University Hospital, Newton.Mei@jefferson.eduGrace Yang, MDThomas Jefferson University Hospital, Grace.Yang@jefferson.eduMital Shah, MDThomas Jefferson University Hospital, mital.shah@jefferson.eduAlbert Lee, MDThomas Jefferson University Hospital, albert.lee@jefferson.eduFollow this and additional works at: http://jdc.jefferson.edu/patientsafetypostersPart of the Medicine and Health Sciences CommonsLet us know how access to this document benefits youThis Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of ThomasJefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarlypublications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers andinterested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion inHouse Staff Quality Improvement and Patient Safety Posters by an authorized administrator of the Jefferson Digital Commons. For more information,please contact: JeffersonDigitalCommons@jefferson.edu.Recommended CitationMei, MD, Newton; Yang, MD, Grace; Shah, MD, Mital; and Lee, MD, Albert, "Improving Colon Cancer Screening in a ResidentAmbulatory Clinic" (2017). House Staff Quality Improvement and Patient Safety Posters. Poster 26.http://jdc.jefferson.edu/patientsafetyposters/26BACKGROUND • Colorectal cancer (CRC) screening has been proven to be a feasible, cost-effective way to reduce incidence of and mortality from CRC. • CRC is the second-leading cause of cancer-related death in the United States.  • As early CRC is asymptomatic, it is imperative that we detect it early to reduce mortality.  • Despite the widespread availability of CRC screening, CRC screening rates in our ambulatory sites have been below average.  • The Wednesday Jefferson Hospital Ambulatory Practice (JHAP) resident clinic’s CRC screening rate was 44.3% in September 2016 as compared to an average of 57% at other ambulatory sites in the Greater Philadelphia region. Therefore, CRC screening was targeted as an area of quality improvement.  • Our goals were to implement an intervention to improve CRC screening rates in our practice as well as identify site-specific obstacles to CRC screening that could be intervened on in the future. • Fecal Immunochemical Test (FIT) is a FDA approved CRC screening modality for one year. AIM STATEMENT Our aim at Wednesday JHAP was to increase the rate of colorectal cancer screenings from 44.3% to 60% from September 2o16 to May 2017 (9 months) INTERVENTION • Our primary intervention was to offer GI referral for colonoscopy, and for  patients who refused screening colonoscopy, FIT was offered as an alternative.  • A secondary intervention was educating residents about the importance of colon cancer screening, how to discuss colon cancer screening options with their patients, and how to teach their patients to properly use FIT kits.  • In November 2016, resident physicians started calling patients who were due for CRC screening to arrange CRC screening. Reasons for patient noncompliance or nonadherence were documented.  • Then, since February 2017, patients who still required CRC screening were again contacted via phone and/or mail to set up CRC screening. RESULTS DISCUSSION Improving Colon Cancer Screening in a Resident Ambulatory Clinic Newton Mei MD*, Grace Yang MD*, Mital Shah MD*, Albert Lee MD Internal Medicine, Thomas Jefferson University Hospital  *The above authors all contributed equally to the project    • Despite not reaching our AIM, we were able to increase our colon cancer screening rate by 16% from 9/2016 to 5/2017 • The most common barrier to colon cancer screening  reported was difficulty scheduling a colonoscopy. Future steps include collaborating with GI to develop a more efficient and effective colonoscopy scheduling system and having multiple resident education sessions to train residents on how to effectively educate patients about FIT as an alternative CRC screening option. • The second most common barrier identified by patients was fear of colonoscopy. We hoped that offering FIT testing would be a suitable alternative for these patients. A future direction is a handout for patients addressing common patient concerns regarding colonoscopy and providing further information to allow for greater patient education and reassurance.    Rreferences: 1. Whitlock EP, Lin JS, Liles E, et al. Screening for colorectal cancer: a targeted, updated systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 2008; 149:638-658. 2. Imperiale TF, Ransohoff DE, Itzkowitz SH, et al, Colorectal Cancer Study Group. Fecal DNA vs. fecal occult blood for colorectal cancer screening in an average-risk population. N Engl J Med 2004; 351:2704-2714. 3. Rozen P, Levi Z, Hazai R, et al. Quantitative colonoscopic evaluation of relative efficiencies of an immunochemical faecal occult blood test and a sensitive guaiac test for detecting significant colorectal neoplasms. Aliment Pharmacol Ther 2009; 29:450-457. 

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Improving Colon Cancer Screening in a Resident Ambulatory Clinic

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