Cancer Screening – Breast

Number of Patients Screened for Breast Cancer
Percent of eligible patients/clients who are up-to-date in screening for breast cancer.

Direction of improvement: increase

breastscreen

Summary/Analysis

Common theme is better data and reminders

Effectiveness:

Kawartha North ? improving data collection by staff

Markham: Participates in CCO funding program for mailing out reminders. Ensure maneuver properly coded in EMR so it is searchable and shows up in the data. Creating next tasks in EMR to help notify patients.

Sunnybrook Academic: mail and electronic reminders improved their measure.

North York: EMR audit to determine eligible patients. Leaving reminder mail outs to CCO to see if there is an increase in response to them rather than to the FHT.

Recommendations:

Utilize the EMR to better track screening status and create proactive reminders. Utilize SAR data to improve data quality
FHTs who only have CCO sending those reminders seem to have an improved rate. Look in to funding from CCO to alleviate the cost of sending out reminders. Having a personalized reminder from CCO has shown to be more effective.

DETAILS

Bancroft????? 51.64 ?> 58.00

  • Identify all patients eligible for screening in EMR and maintain up to date reminder system in EMR -> Reminder done automatically in EMR

?

Kawartha North????? 34.00 ?> 69.00

  • Ensure accurate data collection to ascertain current and future targets
    -> utilize QIDSS position and improved data collection by staff

Aurora ? Newmarket:? 84.00 ?>? 79.00

  • continue to improve EMR so that screening rates are as accurate as possible
  • previous years data may be inaccurate due to insufficient data as well as changes to screening guidelines which has led to discrepancies in completion of testing
  • in depth assessment and consistent documentation has been done in EMR to allow for more accurate summary reports
    • letters will continue to be mailed or emailed to patients bringing awareness to breast screening programs
    • patients will continue to be notified of overdue cancer screening at each visit

Health For All: ?77.00 ?> 75.00

  • determine whether low rates are due to poor screening (declining the screening), poor documentation (screened but not documented) or poor recall (not notifying patients of need for screening)
  • Collaboration of efforts (doctors, inter-professional health and admin staff) to implement improvement efforts
  • Change in performance may be due to different data source
    Positive learning experience:
    Key Learning: there are various data sources available regarding the performance of individual physician?s screening rates. Identifying the appropriate data source is important it forms the basis of our strategies implementation efforts
    Impact of Change Ideas: fostered greater integration among providers and staff; provided new awareness/knowledge of issues in communicating with patients; enhanced team collaboration and communication will support continued improvement
    Advice: designated team to address screening rates is a positive effort

North York FHT: 76.00 ?> 82.00

  • Comment on CCO sending out letters of screening reminders as well?.who gets a better response?
  • Using EMR audits to determine eligible population and of those who have been screened/haven?t been screened
  • Relinquish sending of reminder letters to CCO to avoid duplication of efforts – see if there is a difference in screening uptake based on who sends the reminder out
    • Benchmark against national, provincial, and LHIN performance for each year

Markham FHT: 73.00 ? 82.30

  • Part of QI is not only offer mammography to eligible patients but also ensure the results are properly coded in the chart (so they can be searchable) and to set a reminder to the next screening date. This is a ?preventative care task? or a ?Next Task? in the EMR
    -> it ensures EMR will find maneuver and tally its completion
    -> creates providers and admin a quick view of due dates for next preventable care tasks to assist with future appointments
    -> allows us to contact patients when screening is due as the EMR notifies admin staff to contact patients when needed
  • enhanced communication to remind of screening maneuvers due
  • Using ?Next? task to trigger reminder phone call/email
  • Participate in CCO funding program for mailing reminders
  • Piloting and enhancing planned EMR Patient Portal to potentially fully automate the process

Southlake FHT: —

  • Not participating in this this year

Sunnybrook Academic FHT:? 70.00 ? 78.30

  • Continue with annual mailed out reminders
  • Electronic reminders

-> 100 percent of providers returned their reviewed lists for mail outs
-> email reminder went out however it was discovered that it only works for those never been screened, not those overdue as well