Date of Doctor of Nursing Practice Project Completion
2027
Faculty Advisor
Dr. Marie McBee
Abstract
Purpose: To improve colorectal cancer (CRC) screening completion rates among eligible patients at a primary care clinic, located in Houston, Texas, by optimizing the medical assistant (MA) workflow and addressing systemic and patient-level barriers.
Background: The project site is a Federally Qualified Health Center that provides comprehensive and inclusive care to diverse and underserved populations, including those with low income, living with HIV/AIDS, experiencing homelessness, and uninsured. Despite the availability of non-invasive screening methods like the fecal immunochemical test (FIT), CRC screening rates remain suboptimal due to workflow inefficiencies, patient barriers, and inconsistent follow-up.
Methodology: A multifactorial intervention was implemented to streamline MA workflow and enhance patient engagement. Key components included the use of a standardized narrative script for CRC education, collection education demonstration using an interactive model, and weekly MA-led audits to track test returns, make reminder calls, and review lab results. Additionally, a "return-by-sticker" system was introduced to serve as the first reminder for patients to return FIT kits. The initially planned prepaid postage return option was excluded due to financial constraints.
Results: FIT screening data showed variable completion rates over the first three months of implementation. In January, 25 FITs were ordered with a 40% completion rate (10 returned). In February, 21 were ordered with a 43% completion rate (9 returned). In March, 21 were ordered, but only five were returned, reflecting a 24% completion rate. These trends highlight early successes, but some workflow or patient challenges may still not be being addressed.
Implications for Practice:Standardized workflow modifications and enhanced patient education can positively impact colorectal cancer screening rates. Ongoing monitoring and adaptive strategies are crucial for maintaining momentum. This model may be replicated in other FQHCs to strengthen preventive care delivery for high-risk, underserved populations. By addressing both workflow and patient-level barriers, similar FQHCs can replicate these strategies to improve CRC screening rates and advance preventive care among vulnerable populations.
Keywords
Key search terms included “colorectal cancer screening, ” “increased screening rates in primary care” “primary care medical assistant workflow, ” “patient education, ” “workflow improvement, ” “screening reminders, ” and “primary care screening adherence.”
Recommended Citation
Kathryn Nanji, "CRC Station: Improving Colorectal Cancer screening rates in primary care" (2027). Doctor of Nursing Practice Final Project Abstract. 130.
https://digitalcommons.library.tmc.edu/dnp_abstract/130