Ohio Academy of Family Physicians members have a unique opportunity to take part in a quality improvement (QI) project to increase colorectal cancer (CRC) screening rates in their practice. Designed with the needs of a busy family medicine practice in mind, this program will engage the entire office staff, offer valuable continuing medical education (CME), practice team training, credit toward your American Board of Family Medicine (ABFM) Maintenance of Certification (MC-FP) Part IV requirement, and is provided completely free of charge as a benefit of membership!
Program Components:
- Online CRC screening improvement module that collects patient data, benchmarks results against national standards, helps identify a practice intervention, and re-measures data to show successful improvement. The module is accredited by the American Academy of Family Physicians for 20 CME credits and satisfies the American Board of Family Medicine’s part IV requirement for Maintenance of Certification (MC-FP).
- Three-part CME webinar series focused on QI techniques and patient-centered medical home (PCMH) themes
- CRC screening improvement resources, tools, and templates to support team building and practice improvement
Completing the program is as easy as 1-2-3!
A physician recommendation for screening is the #1 intervention for colorectal cancer detection. The following evidence-based resources provide strategies and tools designed to help your entire care team move your practice to a higher level of performance and every appropriate patient walk out of your office with the needed recommendation:
- A Primary Care Clinician’s Evidence-Based Toolbox and Guide
- How to Increase Preventive Screening Rates in Practice: Action Plan
- CRC Screening Improvement Action Plan Presentation
The CRC screening improvement module, an online professional development tool, is designed to be user-friendly, interactive and help incorporate QI initiatives into your practice, which can impact patient care and outcomes. Through this process, you will identify areas of practice strength and opportunities for improvement through the collection of patient and practice data, develop a QI plan, implement interventions and complete a post-assessment process to determine if improvement was achieved.
- Step-by-Step Module Start-Up Guide
- Video Tutorial on How to Use the CRC Screening Improvement Module
- CRC Screening Improvement Module
(Hosted by the New Jersey Academy of Family Physicians. Accredited by the American Academy of Family Physicians for 20 CME credits. Satisfies ABFM MC-FP Part IV requirement.)
Step 3: Small Test of Change & Re-Evaluation:
Now that you have read the program materials, engaged your entire care team, started collecting patient data, and determined your practice intervention, it is time to put your change plan into action. Follow your QI plan for a minimum of three months, after which you will come back to the online module and enter post-assessment data. At that point, you will be given your pre- and post-assessment measurement results, as well as information about the effectiveness of the interventions and processes you implemented. Once your module is complete, your results will automatically be turned into the AAFP for CME credit and to the ABFM for fulfilling your MC-FP Part IV requirement.
Other Helpful Resources:
- 2011-13 CRC Facts & Figures
- American Cancer Society’s Clinician’s Reference: Fecal Occult Blood Testing (FOBT) for CRC Screening
- Promoting Cancer Screening within the PCMH
- TransforMED Change Management Articles:
Full Facilitation Model
Twenty family physician practices were selected to participate in a hands-on, full facilitation model of the CRC Screening Improvement Project. These practices have agreed take part in a face-to-face training session with a physician peer who has been specially trained in QI techniques and mentorship skills. During their training, each participating practice team will create a customized CRC screening improvement program and establish a team-based office protocol that supports screening improvement.
Full Facilitation Practices:
Akron General Medical Center for Family Medicine
Beavercreek Family Physicians
Byron B. Morales, MD
Center for Family Medicine – Fairview Hospital
Fairborn Medical Canter
Family Health Center – Clinton Memorial Hospital/University of Cincinnati Family Medicine Residency
Huber Heights Family Practice
Metropolitan Family Care
Montrose Family Practice
New London Family Practice LLC
NOMS Family Medicine Associates
North Canton Family Physicians Inc.
North Hills Family Medicine
Northern Ohio Medical Specialists
Premier Physician Center
Rittman Family Practice
Riversedge Family Medicine
Riverside Family Practice Center
Summa Center at New Seasons: Center for Health Equity
Versailles Medical Center
Wyoming Family Practice Center
CRC Screening Improvement Physician Mentors:
Brian Bachelder, MD
Paolo Borges, MD
Debra Gargiulo, MD
Michael Holliday, MD
Neelima Kale, MD
Ryan Kauffman, MD
Robert Kelly, MD
Keith Lehman, MD
Ratna Palakodeti, MD
Jon Seager, MD
Steve Ulrich, MD
Sherry Voet, MD
Terry Wagner, DO
Biplav Yadav, MD
William Sawyer, MD
Statement of Need:
The 2008 Ohio Behavioral Risk Factor Survey indicates that only 51 percent of Ohioans age 50 and older have had a sigmoidoscopy or colonoscopy within the past five years. About 49 percent of Ohioans age 50 and older are not getting screened for CRC.
Data from OCISS for 2003-08 indicates that about 47 percent of all CRCs are diagnosed at regional or distant stage. Each one of these late stage cases was preventable or could have been found at an earlier stage where prompt and appropriate treatment would result in significantly increased survival.
Consultation with colleagues at the ACS East Central Division and a review of recent peer-reviewed published papers regarding CRC screening reveals that barriers to physician referrals for screening include, but are not limited to: (a) outdated knowledge, (b) inconsistent guidelines, and (c) inadequate resources and reinforcement.
Screening through FOBT, sigmoidoscopy and colonoscopy offers opportunities to reduce the incidence of invasive CRC by detection and removal of adenomatous polyps and to reduce mortality by finding tumors at their earliest and most treatable stages followed by appropriate and timely treatment.
Proposed Evidence-Based Intervention:
A collaborative evidence-based intervention to increase referrals for, and completion of, CRC screening is proposed. This will be a collaborative intervention with Ohio Comprehensive Cancer Control Program, ACS East Central Division and OAFP.
OAFP is a dues-funded, statewide professional association with more than 4,100 members, including practicing physicians, residents, and medical students. OAFP members are high-profile primary care providers in an excellent position to increase referrals and to track the referrals for completion for CRC screening. The peer-reviewed published literature and consultations with ACS and OAFP clearly demonstrate that a recommendation from a primary care physician is the strongest predictor for a patient to be screened for CRC.
This intervention will focus on OAFP members using the professional education materials developed by Thomas Jefferson University Department of Family Medicine in collaboration with ACS: How to Increase CRC Screening Rates in Practice: A Primary Care Clinician’s Evidence-Based Tool Kit and Guide. These professional education materials include three evidence-based strategies to increase CRC screening rates: (1) office policies, (2) reminder systems, and (3) communication. Other activities will include: (4) establishing a baseline CRC screening rate for the practice, and (5) tracking the completion of CRC screening to detect if an increase in screening is taking place as a result of the professional education intervention.
If you have questions regarding this program, please contact Deputy Executive Vice President Kate Mahler, CAE, or call 800.742.7327.
