|
|
About the Initiative
The Cervical Cancer Advisory Committee (CCAC) felt that
having labs contact women directly about abnormal Pap results (rather than assuming
the clinician was doing so) might encourage the women to have follow-up
diagnostic testing. A subgroup of the CCAC designed a pilot project in which a clinical laboratory contacted women directly, in writing, to inform them of abnormal or unsatisfactory Pap test results.
Impetus for the Collaboration
According to the U.S. Centers for
Disease Control and Prevention, 10 percent to15 percent of invasive cervical cancer is due to
women with abnormal Paps who are lost to follow-up.
Results
Although process data were the
primary focus of the pilot project, the team was able to document both process
and outcome data.
The lab was able to notify 99.8 percent of the women about their abnormal
or unsatisfactory results. The lab documented that 78 percent of women with abnormal
Paps (HSIL, AGC, SCC, AIS) had appropriate follow-up pathology received by the
lab. In some of the remaining cases, appropriate follow up was done, but not reported to the lab.
After implementation, about half of the providers who provided feedback on the system said that the pilot notification system had "probably" or "definitely" reduced risk to them as a provider. Although there was mixed feedback about its value or impact, 61 percent of responding providers said this method of notification should be implemented on a permanent basis.
Lessons Learned
The pilot study was specifically evaluated for feasibility and acceptability, and the collaboration partners identified several valuable lessons learned for the both preparation and implementation aspects of the patient notification system.
In the preparation stage, the roll-out to the providers and health system is crucial to buy-in. The preparation must include efforts to understand medical staff concerns and address them. The patient notification letter must be generic, linguistically simple, and non- technical.
During implementation, the notification system should allow a two-week delay between when results are sent to the provider and when the notification letter is sent to the patient. Notification letters should be mailed on a Monday, so they are not delivered on a Friday or Saturday.
In addition, the team identified the following elements as requirements for a well-functioning patient notification system: knowledgeable staff to design and initiate the program; dedicated staff to maintain program; pre-existing informatics system and a programmer for pulling data; and providers' approval of the system.
- Carolyn Johnston, MD, University of Michigan Health System
- Carl Christensen, MD, PhD, Detroit Medical Center (both gyn/onc)
- Frances Pouch Downes, MD, PhD, Michigan Department of Community Health (laboratories)
- Samuel Hirsch, MD, St. Joseph Mercy Health System
- Mutjaba Husain, MD, Detroit Medical Center (all cytopathologists)
- Rachel Nosowsky, JD, University of Michigan Health System (risk management)
- Maureen O'Higgins, MS, RN, American Cancer Society
- Emily Volk, MD, Beaumont Hospital
- Lauren Zoschnick, MD, University of Michigan Health System (ob/gyn)
MCC Recognition
Cervical Cancer Advisory Committee's Workgroup on Patient
Notification of Abnormal Pap Test Results received the Michigan Cancer
Consortium’s 2006 Spirit of Collaboration Award. The annual award is presented to member organizations that have done outstanding collaborative work to significantly move comprehensive cancer control activities forward in Michigan.
Learn More
For more information about this project, please contact:
Return to top of page
last updated: 01/23/07
|
|
|||
| Washington Square Building, 5th Floor ·
109 Michigan Ave. ·
Lansing, Michigan USA 48913 Toll-Free: (877) 588-6224 · Fax: (517) 335-9397 ·  |
Tell us what you think about this Web site. Take our survey.
Copyright 2000-2008, Michigan Cancer Consortium
Editorial
Policy · Disclaimer · Site Index