Methods: 
Study sought to determine if an intervention would aid in increasing mammogram screening rates in the Jefferson Family Medicine Associates practice.https://jdc.jefferson.edu/patientsafetyposters/1061/thumbnail.jp

LaPorta, MD, Jennifer

Leshner, MD, Amy

Love, MD, Gillian

McClowry, MD, Robert J.

McIntosh, MD, Lionel

McManus, MD, Patrick

Rague, MD, Allison

Sizemore, MD, Daniel

Talley, MD, Elizabeth  Mackie

Thesing, MD, Claire

English

Jefferson Digital Commons

Thomas Jefferson UniversityJefferson Digital CommonsHouse Staff Quality Improvement and PatientSafety Posters GME Quality and Safety5-31-2017Addressing Barriers to Breast Cancer Screening:Where to Intervene to Increase MammogramCompletion RatesJennifer LaPorta, MDJefferson Family Medicine, Thomas Jefferson University, jennifer.laporta@jefferson.eduRobert J. McClowry, MDThomas Jefferson University, robert.mcclowry@jefferson.eduElizabeth "Mackie" Talley, MDJefferson Family Medicine, Thomas Jefferson University, elizabeth.talley@jefferson.eduLionel McIntosh, MDThomas Jefferson University, lionel.mcintosh@jefferson.eduAllison Rague, MDThomas Jefferson University Hospital, allison.rague@jefferson.eduSee next page for additional authorsFollow 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 CitationLaPorta, MD, Jennifer; McClowry, MD, Robert J.; Talley, MD, Elizabeth "Mackie"; McIntosh, MD, Lionel; Rague, MD, Allison;Thesing, MD, Claire; Leshner, MD, Amy; Love, MD, Gillian; Sizemore, MD, Daniel; and McManus, MD, Patrick, "Addressing Barriersto Breast Cancer Screening: Where to Intervene to Increase Mammogram Completion Rates" (2017). House Staff Quality Improvementand Patient Safety Posters. Poster 47.http://jdc.jefferson.edu/patientsafetyposters/47AuthorsJennifer LaPorta, MD; Robert J. McClowry, MD; Elizabeth "Mackie" Talley, MD; Lionel McIntosh, MD;Allison Rague, MD; Claire Thesing, MD; Amy Leshner, MD; Gillian Love, MD; Daniel Sizemore, MD; andPatrick McManus, MDThis poster is available at Jefferson Digital Commons: http://jdc.jefferson.edu/patientsafetyposters/47INTRODUCTION Breast cancer is the second leading cause of cancer death in women in the USA.  Mortality rates have decreased 2.2% per year since 1990, much of which is attributed to mammography.  • Mammogram is effective for early detection of primary breast cancers – 97% 5-year survival rate in those with localized disease – 20% 5-year survival rate in those with metastatic disease  • United States Preventative Services Task Force (USPSTF) and American College of Family Physicians (AAFP) recommend biennial screening of women for breast cancer between the ages of 50 and 74 (Grade B)    • American College of Gynecology (ACOG) and American Cancer Society (ACR) recommend annual breast cancer screening of women for breast cancer between the ages of 50 and 74. (Qualified recommendation)   • USPSTF and AAFP agree screening women 40-49 years old only after a discussion between the patient and the provider (Grade C) METHODS Study sought to determine if an intervention would aid in increasing mammogram screening rates in the Jefferson Family Medicine Associates practice.      • Intervention would provide informational handouts to patients along with the mammogram order form prior to discharge from the office – Mammogram scheduling instructions at Jefferson Breast Center – Mammogram education  • Training for Team 3 medical assistants • Email to Team 3 providers outlining the new intervention • Inclusion Criteria – Women – 40-74 years of age – Patients seen in Team 3 – Mammography due at time of visit: • Due: last mammogram 12 months or greater from date of appointment • Not Due: Mammography performed in last year from date of appointment.  • Pre-intervention Control Period: 1/1/17-1/31/17 – Mammography to be completed by 3/14/17 • Intervention Period: 2/1/17-2/28/17, Handout Provided – Mammography to be completed by 4/11/17  RESULTS LIMITATIONS • The most conservative inclusion criteria used – All women 40-74 were assessed according to annual screening criteria – Did not screen for women on biennial screening schedules – Did not screen for women who through shared decision making with their physicians have different screening schedules  • Transition to Epic electronic medical record changed office practices  – Accuracy of Health Maintenance tabs not fully assessed in transition – Epic requisition forms have scheduling information included  – Planning of the study was based on different office practices  – Change of MA practice ad workflow  • Unable to reliably track if intervention handouts were given to patients • Patients attending acute care visits were included in final analysis • Months with differing number of days were compared in final analysis   CONCLUSIONS  • The intervention made had no statistically significant difference on the outcome measured • There was no improvement in mammography completion rates  • Individual providers and teams collectively are missing opportunities to discuss mammography with patients • This should be where an intervention is made.  • Lack of mammogram completion rates largely influenced by missed opportunities to order the study and discuss the specifics of the study with patients.        REFERENCES Baquet, Claudia R., and Patricia Commiskey. "Socioeconomic factors and breast carcinoma in multicultural women." Cancer 88.S5 (2000): 1256-1264.  Barnoy, Sivia, Yoram Bar-Tal, and Lilit Treister. "Effect of unrealistic optimism, perceived control over disease, and experience with female cancer on behavioral intentions of Israeli women to undergo screening tests." Cancer nursing 26.5 (2003): 363-369. Dershaw, D. David, et al. "A comparison of screening mammography results from programs for women of different socioeconomic status." Cancer 82.9 (1998): 1692-1697. Fulton, John P., et al. "A study guided by the Health Belief Model of the predictors of breast cancer screening of women ages 40 and older." Public Health Reports 106.4 (1991): 410. Siu, Albert L. "Screening for breast cancer: US Preventive Services Task Force recommendation statement." Annals of internal medicine 164.4 (2016): 279-296.  Tria, Tirona M. "Breast cancer screening update." American family physician87.4 (2013): 274-278. VanDyke, Santana D., and Madelynn D. Shell. "Health Beliefs and Breast Cancer Screening in Rural Appalachia: An Evaluation of the Health Belief Model." The Journal of Rural Health (2016).   Addressing Barriers to Breast Cancer Screening: Where to Intervene to Increase Mammogram Completion Rates Jennifer LaPorta, MD,  Robert McClowry, MD, Elizabeth Talley, MD, Lionel McIntosh, MD, Allison Rague, MD, Claire Thesing, MD,   Amy Leshner, MD, Gillian Love, MD, Daniel Sizemore, MD, R. Patrick McManus, MD Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia PA STATISTICAL ANALYSIS Figure 1. Daily percentage representation of total mammograms ordered, mammograms ordered and completed by patients and mammograms ordered and not completed by patients.     Figure 2. Comparison of percentage representation of total missed opportunities for mammograms to be ordered, mammograms ordered and completed by patients and mammograms ordered and not completed by patients in the pre and post intervention periods.     • Comparative Error was utilized in order to assess for statistical significance of the intervention • The calculated comparative error was 11.33 and the absolute percentage difference was 4% • As the comparative error is greater than the absolute percentage difference, there was no significant difference caused by the intervention.    

Addressing Barriers to Breast Cancer Screening: Where to Intervene to Increase Mammogram Completion Rates

Methods: 
Study sought to determine if an intervention would aid in increasing mammogram screening rates in the Jefferson Family Medicine Associates practice.http://jdc.jefferson.edu/patientsafetyposters/1061/thumbnail.jp

Talley, MD, Elizabeth \u22Mackie\u22

Name not available

https://jdc.jefferson.edu/cgi/viewcontent.cgi?article=1061&amp;context=patientsafetyposters

Addressing Barriers to Breast Cancer Screening: Where to Intervene to Increase Mammogram Completion Rates

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