306 Multicenter Success Increasing Colorectal Cancer Screening at Federally Qualified Healthcare Centers (FQHCs)

Abstract

INTRODUCTION: Colon cancer is the second leading cause of cancer-related death in Georgia with 1,400 annual deaths. Colon cancer incidence and mortality decreases by 61% when patients are appropriately screened using American College of Gastroenterology recommendations. While the national screening rate is 71% and the statewide rate is 68%, at Georgia’s Federally Qualified Healthcare Centers (FQHCs), which serve 494,464 underserved patients yearly, the screening rate was only 32% in 2017. METHODS: Between April 2018 to July 2018, two physicians with an interest in colon cancer conducted quality improvement at four FQHCs around the state in an attempt to bridge that gap in screening. The team provided educational lectures about colon cancer to providers, reviewed screening processes to identify gaps and used ACG guideline recommendations to help clinics develop a screening policy to help ensure eligible patients get screened. They also provided patient education materials such as brochures, posters, and postcards. As a federal grant requirement, FQHCs are required to report colon cancer screening rates using a federal government system called electronic Clinical Quality Improvement. Screening rates are calculated by dividing all eligible patients who have received screening by total patients eligible for screening. These rates were collected to track quality improvements. RESULTS: Screening rates increased at all sites 3 months post-intervention. Site 1: 41% to 48.4%; site 2: 31.6% to 37.8%, site 3: 30.5% to 38.2%, site 4: 43.9% to 46.8%. CONCLUSION: We demonstrate success of a physician driven program to increase colon cancer screening rates at four federally funded clinics for the underserved in Georgia. A total of 10,933 unscreened patients were at the clinics prior to the project and screening increased from a range of 2.9% to 7.7%. A multifaceted approach included the following: 1-direct provider education sessions, emphasizing ACG tier 1 screening, especially FIT tests 2- technical expertise in making process improvements 3- providing patient education resources. These low cost strategies increased screening rates. Based on the results of this study, this program should be scaled to FQHCs around the country and would be expected to improve colon cancer mortality for the nation's underserved patients.