Improving ACO Metrics through Interprofessional Collaboration on Colorectal Cancer Screening

Abstract

Colorectal Cancer screening is a leading cause of cancer-related deaths in the United States. Preventative screenings help to reduce mortality and economic burden of this disease through early detection. Accountable Care Organizations aim to adhere to guidelines set forth by the Centers for Medicare and Medicaid Services and the United States Preventive Services Task Force. This quality improvement project was conducted as a result of the identified need to increase colorectal cancer screenings at an academic medical clinic in the southeastern United States. Clinic leaders identified a screening referral rate of 57% for eligible patients. The recommended colorectal cancer screening referral rate for eligible patients is 80%. To increase the number of referrals, reminders were added to routine patient care including electronic health record “reminder notes” and stool emoji stickers placed strategically in the clinic to assist clinicians with initiating discussing screening with patients and ordering screening for colorectal disease. The intervention was implemented from August 20, 2018 to December 13, 2018 and included 50 random chart audits to collect data. Data were analyzed including patients age, eligibility for colorectal cancer screening, referrals made, and documentation that referral notes were received following the patient visit. Rapid change cycles were used; monthly discussions and adjustments to micro-interventions were made by an interprofessional team. At the completion of the project, the site referral rate was 72%. The site improved colorectal cancer referrals 2% during the implementation period and 15% over the fiscal year.