Innovation in Cancer Screening through Quality Improvement

Abstract

Theme: Evaluation, Monitoring and Quality Improvement Innovation in Cancer Screening through Quality Improvement\xa0 Introduction\xa0 The\u202fCommunity-led Cancer Screening Project (CLCSP) funded by the Victorian Department of Health and Human Services is a three-year project being run in partnership with the North Western Melbourne Primary Health Network (NWMPHN), and two other Primary Health Networks in Victoria.\xa0 The project\u202faims to increase participation in bowel, cervical and breast cancer screening programs by building capacity within primary care and through facilitated targeted community-led interventions. The project focuses on under-screened communities including Culturally and Linguistically Diverse (CALD), Aboriginal and Torres Strait Islanders\u202fand people experiencing socio-economic disadvantage.\xa0 This abstract focuses on the building capacity within primary care aspect of the project.\xa0 Practice change implemented Evidence shows higher cancer screening participation rates with greater involvement of primary care1. This project works with\u202fgeneral\u202fpractices to understand the challenges and barriers to screening and to support practices to undertake activities to increase screening rates in these populations. Aim and theory of change Practices will undertake practice-based quality improvement (QI) activities using the Model for Improvement (MFI) methodology, which provides a framework for practices to develop, test and implement changes using Plan, Do, Study, Act (PDSA) cycles.\xa0 Practices will participate in three workshops that will provide clinical updates on cancer screening and the MFI methodology, and facilitate peer-to-peer learning. Practices receive in-practice support from NWMPHN staff throughout. Using the MFI methodology practices implement changes to work towards increasing cancer screening rates. Through this process screening rates are increased, particularly for under-screened populations. Targeted population and stakeholders Brimbank\u202fand Wyndham Local Government Areas were selected\u202fto be the focus of this activity due to low screening rates. Specifically, the CALD community and people of low socio-economic status in Brimbank and the Aboriginal and Torres Strait Islander community in Wyndham. Timeline The activity commenced in May 2019 and will be implemented over 12 months.\xa0\xa0 Highlights Development of a cancer screening QI toolkit in collaboration with participating PHNs Practices recruited by a selection panel that included a GP and community member\xa0 Development of data reports\xa0 Completion of pre-activity confidence surveys – 23% participants not confident with cancer screening, 46% partially confident, 27% entirely confident\xa0\xa0 Sustainability The activity aims to embed QI and develop clinical champions who can continue to support initiatives to improve cancer screening and mentor others. \xa0Transferability Practices will become confident in QI methodology that they can apply to other diseases/conditions. They are also provided the opportunity to share learnings with peers. Conclusions The MFI has been demonstrated to improve practice-level outcomes. We expect that using this methodology practices will see increased cancer screening rates in underscreened populations. \xa0Further results available in November. Discussions\xa0 Initially, participating practices are focusing on data cleansing, identifying eligible patients and actively recalling them.\xa0 Further analysis of results available by November. Lessons learned The MFI is a well-accepted model for implementing change in general practice to achieve improvements such as improved cancer screening\xa0 Access to specialists is key to engaging practices