ASPO Abstracts
Healthy Colon, Healthy Life: Improving Wait Times for Colonoscopy after Colorectal Cancer Screening
Category: Early Detection & Risk Prediction, Behavioral Science & Health Communication
Conference Year: 2018
Abstract Body:
Purpose This project aims to increase the proportion of timely colonoscopies after positive FOBT to 85% by April 2018. Description Fecal Occult Blood Tests (FOBTs) indicate blood in the stool, a potential sign of colorectal cancer. Colorectal cancer is the second leading cause of cancer deaths in Ontario, but is treatable if detected early. According to Cancer Care Ontario, a follow-up colonoscopy is required within 56 days to determine if polyps are truly present. At Niagara Health, positive FOBT colonoscopies are not always performed within the target wait time. Given that research outlines that timeliness of positive FOBT colonoscopies impacts the quality of patients’ lives, a quality improvement initiative has been undertaken to determine appropriate changes. Methods An interdisciplinary team focused on improving the central referral system, which books colonoscopies within 56 days based on specialist availability. Targeted data analysis revealed that increased family physician utilization of the central referral system should decrease wait times. An information package about the central referral system was developed and distributed through an awareness campaign for family physicians in the Niagara Region. Results Data analysis revealed stagnant rates of meeting the target wait time over the past few years and highlighted large variations in wait times by physician group. Colonoscopies scheduled through the central booking system consistently met the 56 day wait time; however, the proportion of colonoscopies booked through the central system was low. Engagement with family physician offices, through personal interactions with office staff and targeted follow-up calls, appeared to increase awareness of the central referral system. Conclusions This project demonstrates how quality problems, such as long wait times for positive FOBT colonoscopies, may already have a solution but require increased buy-in to the improved system and sustained program momentum. Personal visits to physician offices may build buy-in to the central referral system, reduce colonoscopy wait times and ultimately improve the colorectal health of Ontarians. This timeliness is particularly relevant given the upcoming shift to Fecal Immunochemical Test (FIT) screening.
Keywords: Screening Wait Times Colorectal Central Referral