Evaluation of a cervical cancer surveillance program at a community health center

Background: Cervical cancer is reportedly the easiest gynecologic cancer to prevent, and measures that have the most impact are regular screening and timely follow-up. Although the Papanicolaou (Pap) test used to screen for cervical cancer has been recognized as one of the most valuable clinical preventive service for women, variation in screening and tracking remain a barrier for some women achieving optimal health. Missed opportunities for care in the form of inadequate follow-up is a patient safety and quality of care issue that can be appropriately addressed through implementation of a tool to be used as a component of a cervical cancer surveillance program. Purpose: The purpose of this quality improvement (QI) project was to develop an evidence-based, tracking tool for cervical cytology screening to facilitate surveillance measures in a community health center. Theoretical Framework: The theoretical framework applied was Donebedian’s quality of care framework that incorporates the Structure-Process-Outcome model. Methods: The study was conducted in five phases over a period of 14 months. After permission was granted to implement the study, the tracking tool was developed with input from the mentor. The final two phases consisted of training, implementation, and evaluation of tool’s effectiveness towards improving practice. A survey questionnaire measuring the staff’s opinion of the tool was administered and verbal feedback regarding perception of the tool’s capability to impact clinical practice was collected. Results: Informal surveys were performed by asking stakeholders to share their attitudes and opinions of the surveillance tool. Conclusion: Consistent evidence-based practice among those charged with providing care is paramount to helping patients achieve their best outcome. Surveillance is an internal process and improving surveillance is pivotal to the goal of optimizing outcomes. The findings of the QI project indicate that through the provision of this evidence-based practice, clinical resource, quality of care will be improved. Additionally, the surveillance tool will be incorporated into clinical practice and used as the official method for tracking abnormal cervical cancer screenings, scheduling follow up care, and tracking patients until resolution of cervical pathology