Evaluation of a Process Change on Mammography Screening Rates in a Family and Community Medicine Clinic

Abstract Background and Significance: Breast cancer is the 2nd leading cause of cancer death among women worldwide. Mammography is a screening approach used in the detection of breast cancer and proven to help reduce mortality. Only 72.8% of eligible American women have been screened for breast cancer within the past 2 years. One urban family and community medicine clinic (FCM) fell below the national average with a rate of 60.9%; as a result, they implemented an evidence-based strategy to improve mammography rates within the clinic. Purpose: The purpose of this study was to evaluate the implementation of a telephone outreach with direct scheduling intervention within the FCM Clinic and Women’s Health (WH) Clinic. Methods: The study design was a descriptive study with a comparison group to evaluate a process change in ordering and scheduling mammograms. A chart audit and a perceived barriers survey was conducted at the FCM Clinic and the WH Clinic, the comparison group. Results: A total of 200 patients (100 pre, 100 post) were analyzed at the FCM and WH Clinic. There was a non-significant increase in mammography completion at the FCM Clinic from 20% (n = 10) pre- to 32% (n = 16) post-intervention. There was a significant increase (p = 0.04) in mammography completion at the WH Clinic from 66% (n = 33) pre- to 84% (n = 42) post-intervention. Providers’ perceptions of barriers to mammography completion were time constraints and fear of mammography-related pain. Conclusion: Telephone outreach with direct scheduling was found to be an effective method for increasing mammography rates. However, the addition of a proactive approach to ordering and scheduling mammograms could increase rates to meet or exceed the quality measure target. Keywords: mammography, breast cancer screening, telephone outreac