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Increasing Colorectal Cancer Screening Using a Quality Improvement Approach in a Nurse-Managed Primary Care Clinic

Hountz, Diane; Coddington, Jennifer; Foli, Karen J.; Thorlton, Janet

The Journal for Healthcare Quality (JHQ): November/December 2017 - Volume 39 - Issue 6 - p 379–390
doi: 10.1097/JHQ.0000000000000107
Original Article
Continuing Education

Abstract: According to the American Cancer Society, 1 in 23 Americans will be diagnosed with colorectal cancer (CRC) in their lifetime. Screening for CRC is an effective, yet underused preventive approach. This is especially true in rural areas, where only 35% of patients were found to be up to date on their screenings in 2014. Increasing CRC screening can produce positive patient outcomes by early recognition and removal of precancerous polyps. The purpose of this project was to use quality improvement (QI) interventions to increase CRC screening rates at a nurse-managed clinic in rural Indiana. Using Deming's Plan-Do-Study-Act QI model, multiple interventions were implemented which resulted in a 37% increase in the number of screenings ordered on eligible patients and an overall increase of 28% in the completion of the screenings. This project contributes to healthcare quality knowledge by also suggesting that the fundamental principles of encouraging staff feedback to gain buy-in, improving processes informed by patient data, and valuing frequent performance feedback to staff, strengthened this QI project and ensured adoption and sustainability of these results.

For more information on this article, contact Jennifer Coddington at

The authors declare no conflicts of interest.

© 2017 National Association for Healthcare Quality
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