Evaluation of a National Quality Improvement Collaborative for Improving Cancer Screening
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Published:2022-11-16
Issue:11
Volume:5
Page:e2242354
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ISSN:2574-3805
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Container-title:JAMA Network Open
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language:en
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Short-container-title:JAMA Netw Open
Author:
Joung Rachel Hae-Soo1, Mullett Timothy W.23, Kurtzman Scott H.45, Shafir Sarah6, Harris James B.27, Yao Katharine A.48, Bilimoria Karl Y.1, Cance William G.69, Nelson Heidi2, Abedi Ali10, Acharya Sheetal10, Adams Karen T.10, Agarwal Rishi10, Agarwal Sachin10, Ahmad Rima10, Albaneze Philip10, Aldis Kimberly10, Allen Ahkeel10, Allman Shayla10, Alsen Meiling10, Ansteth Mindy10, Appiah Angela A.10, Arentz Candy10, Arias Amanda (Lori)10, Armetta Christine10, Arnold Alicia H.10, Arsene Camelia10, Arthur Karen10, Ashton Brandon10, Atassi M Bassel10, Attia Sameh10, Bahna Heidi10, Bailen Laurence10, Baker Thelma10, Balan Stefan10, Balis Amy10, Balsley Anne10, Barajas Denise10, Barone Julie L.10, Batchelor Brett10, Bates Elizabeth10, Bayliss Trevor10, Beck Susan10, Bennett Brandon10, Bennett Ryan10, Bennett Nathan10, Bensenhaver Jessica10, Berby-Todd Jane10, Berrocal Julian10, Bertoni Danielle10, Bevan Alison10, Bhatti Rabia10, Bier-Laning Carol10, Blackwood Margaret M.10, Blake Kenneth10, Blankner Joanna G.10, Blansfield Joseph A.10, Blaszkowsky Lawrence10, Blonigen Brian10, Bloom David10, Boatsman Justin10, Boggs Jonathan10, Bold Richard10, Bollinger Deborah10, Bolton Cheryl10, Boolbol Susan10, Boone Greg10, Borges Lawrence10, Bouton Michael10, Bovest Carol L.10, Bowman Seitz Tara10, Boyer Carol10, Boyle Colton10, Bracho Francisco A.10, Bragg Autumn10, Branton Susan10, Breslin Tara M.10, Brock Melissa N.10, Broder Arkady10, Brown Christine10, Brown Bradley10, Brown Holly10, Brown Lisa M.10, Brown Richard10, Bruce Laura10, Bruce Sara10, Bruton Catherine10, Bryant Karen10, Burak William10, Burgers Jessica10, Busch Kristin10, Caba David10, Cain James10, Campbell Matthew10, Campo Cynthia10, Canavan Lynn10, Cannick Leander10, Caputo Paula10, Carr H. Janelle10, Casteel Christina10, Cattaneo Stephen10, Cecil Austin10, Celano Paul10, Chambers Karinn10, Chambers Stella10, Chin Janet10, Christian M Kathleen10, Chu Crystal10, Church Allison10, Clark Jamie10, Clark Lynne P.10, Clements Marsha10, Cohen Seth10, Cole Cathy J F10, Colemire Danielle10, Compton Julia10, Connery Cliff P.10, Constanza-Guaqueta Delia10, Contreras Stacey10, Coon Alan B.10, Copelen Kathleen L.10, Corral Javier10, Cosio Rosa10, Costas Kimberly E.10, Cox April10, Cox John A.10, Crane Erin P.10, Crotzer David10, Cruz Celeste G.10, Cygan Angelique10, Cyphers Lisa10, Czerlanis Cheryl10, Dale Paul S.10, Danak Shivang10, Dang Pragya A.10, Darcourt Jorge G.10, Davuluri Raj10, Day Barbara10, DeAntonio Phyllis10, Der Yamile10, DiAddezio Nelah10, Dietrich Leah L.10, Diller Edma10, Dodge Tanya10, Domenech Gabriel10, Donovan Diana10, Dubil Elizabeth10, Dunn Gary10, Ebling Lindsay10, Edsall Bonnie10, Eftimie Bogdan10, El Mouallem Nemer J.10, Eladoumikdachi Firas10, Elliott Joy10, Elliott Katie10, Ellis Melissa10, Endo Kenneth10, England Trisha10, Ennis Carrie10, Everhart Toni10, Evins Amy10, Facktor Matthew A.10, Fadel Celine10, Farrell Michael10, Fawley Diane10, Feldman Elizabeth D.10, Finan Michael A.10, Fintel Andrew10, Fleshman James10, Fogarty Sara P.10, Fontanilla Hiral10, Fontenot Eric C.10, Foran Jon10, Foss-Blizard Chaundra10, Frank James10, Franz Julie10, Freeman Lu10, Freter Rolf10, Fried Steven10, Gabriel Ryan10, Galbraith Joan10, Garcia Johanny10, Gardner Kim10, Geary Karen10, Gemmel David J.10, Gerlach Jessica10, Ghee Lauren10, Ghisoli Maurizio10, Giannone Deborah10, Gibbons Courtney10, Gillis Paul10, Gilmore Denis10, Gonzalez Victor J10, Gooley Leann10, Gorrell Christine10, Grady Sally10, Grew David10, Grisby Shaunda10, Guerra Carmen E.10, Guerriero Jacqueline10, Gupta Kunal10, Gynn Michael10, Hafertepen Laura10, Hale Christy10, Hallenbeck Ryan10, Hals Ladonna10, Hammons Emmy L.10, Haramati Linda B.10, Harper Natalie W.10, Harris James10, Harrison Meredith A.10, Harrison Miranda10, Hassapis John10, Haverlock Betty10, Hawley Aimee10, Hayden Theresa10, Hayes Cherylle10, Hayes Dawn M.10, Headen Carole10, Hehnly Erika10, Heikens Sarah10, Heinzman Stephen10, Herring Mary E.10, Hill Michelle10, Hirner Patricia10, Hobbs Kiera10, Hordyk Heidi10, Horning Neil10, Howard Donna10, Huang Kan10, Hughes Corilynn10, Hughes Jenevieve10, Huibregtse Carol10, Huitt Nancy10, Hunsucker Laura10, Inverso Tina10, Irwin Tonia10, Isbell Melanie10, Jabbour Nicola10, Jackson Mia L.10, Jackson Raymond10, Jacob-Perez Sherly10, Jafri Nazia10, Jahania Salik10, Jarrett Adam10, Jenkinson Scott10, Johnson Richard10, Johnson Anna10, Johnson Dianne10, Johnson Patricia10, Johnston Catherine10, Jones Roberta10, Jones Susan10, Joseph Joyce10, Joseph Natalie E.10, Joyner Robert L.10, Juarez-Perez Maria10, Kaczmarski Kimberly10, Kakani Vijaya10, Kamran Amir10, Kanaan Samer10, Kang Tyler10, Kannarkatt Joseph10, Kanneganti Shalini R.10, Kantharaj Belagodu10, Kaufman Howard10, Keeler Vickie10, Keiser Shanna10, Kennedy Malissa10, Khan Iftekhar10, Khan Raza10, Kibel Lesley P.10, Kiernan Marianne10, Kim Brian10, Kinnaird Adriene10, Kipping-Johnson Kristen L.10, Kirkland Peggy10, Kirshnan Sandeep10, Klaff Lindy10, Kloss Robert10, Klotz Jeffrey K.10, Knight Susan10, Koch Julie10, Kocheril Paul G.10, Kodali Dhatri10, Kohli Manpreet10, Koko Isoken10, Kong Amanda L.10, Kozyreva Olga10, Kraft Lorei A.10, Krisher Stacy10, Kruse Edward J.10, Kupstas Amanda10, Kurian Mini10, Kwait Rebecca10, Lan Cynthia10, Lanciano Rachelle10, Lannon Wendy10, Laster Sydney R.10, LaTrenta Linda R.10, Law Suzanne A.10, Le Isabelle10, Lean Nancy10, Leatherbury Keith10, Lee Jacqueline10, Leete Tyler10, Legenza Mary10, Leung Winifred K.10, Li Jongming10, Likhacheva Anna10, Lingerfelt Brian10, Llaguna Omar H.10, Longo Laura10, Loop Melissa10, Lopez Nicholas10, Loporchio Nancy10, Lowney Jennifer10, Lozoraitis Carisa10, Lu Kit Y.10, Lue Deborah10, Lush Richard10, Luyimbazi David T.10, Lyons Debra10, Macedo Francisco I.10, Machenzie Michelle10, Mack David10, Mack Julie10, MacVicar Jessica10, Mah Kathleen L.10, Mahoney Kathryn10, Makani Neeharika S.10, Makower Della10, Malad Salman10, Maldonado Cynthia10, Malik Farhana10, Malone Angie10, Mantha Suparna10, Marczak Kristina10, Margolis Nathaniel10, Mashanic Kathleen10, Mathison Jill10, Mauzy Tiffany10, Maxwell Leslie10, McAllaster Jennifer10, McCarthy Caitlin10, McClune Jason10, McColgan Jennifer K.10, McCusker Teresa10, McDaniel Dana10, McFayden Lynette10, McGivney Randall10, McGovern Kerri10, McKeever Hannah10, McManus Susan10, McNair Kate10, McNeil Heather10, McRae Jennifer10, Medrano Consuelito A.10, Mehta Pallav10, Merrigan Tricia10, Meyers Eva10, Mickey Suzanne10, Miller Jackie10, Miller Luke10, Miller Stephanie10, Mink Tara10, Miranda Jodi10, Mitchell Mary M.10, Monroe Julie10, Moore Joyce10, Morin-Ducote Garnetta10, Moritz Troy10, Morris Paul T.10, Mukherjee Sumit10, Mullally Sean D.10, Mulligan Margaret10, Mullins David A.10, Mullins Mary10, Munoz Ivonne10, Murdock Jeremy J.10, Myers Stacie N.10, Nair Sindhu10, Nandamuri Kiran10, Nicholls Joanne10, Nick Donna10, Nish Andrew10, Nowell Andrew10, Nowell Kerri10, O'Connor Lynn M.10, O'Neill Judy10, O'Riordan Moira10, Ogunkunle Roselyn10, Opsasnick Margo M.10, Ortiz Cindy A.10, Osgood Rebecca10, Oxenberg Jacqueline10, Page Brandi R.10, Palmer Jacquelyn A.V.10, Parikh Dhaval K10, Park David J.10, Partin Jessica10, Passwater Chelsea10, Patel Mita10, Patrick Jilma10, Patterson Shauntee10, Pearson Laura10, Peiffer Susan10, Peralta Elizabeth10, Peterson Mary10, Pettus Benjamin10, Pezzulo John10, Pfarr Megan10, Phelps Connie10, Phillips Lacy10, Pick Matthew10, Piephoff James10, Pinkston Jodee10, Piper Jessica10, Pollak Stanley B.10, Ponec Robert10, Popalzai Muhammad J.10, Pories Susan E.10, Prieto Robert10, Proctor Kerry10, Provost Karla10, Prow Debra10, Puc Matthew10, Purdon Mary10, Quaranta Brian P.10, Quinlan-Davidson Sean10, Rabines Alfredo10, Rahman Rakhshanda L.10, Ramasubbaiah Rashmi10, Ramírez-Solá Maricarmen10, Randolph David10, Raskin Elizabeth R.10, Rasmussen Linda10, Rasmussen Nicole10, Rasmussen Ronald10, Reed Clinta C.10, Reese Shellee10, Regis Shawn M.10, Reilly James10, Reitherman Richard10, Reneau Curtis10, Renfroe Connie10, Renn Carol10, Reyna Chantal10, Rieger-Christ Kimberly10, Ringer Rochelle10, Rizack Tina10, Rizwan Uzma10, Robinson William R.10, Robles-Rodriguez Evelyn10, Rogers Ethan S.10, Ronk Melissa10, Rossidis George10, Rovito Marc A.10, Roy Abhik10, Roybal Lisa10, Ruggiero George10, Ruskin Rachel10, Ryan Jessica10, Sachdeva Kush10, Saffie Anne10, Sall Noura10, Salters Dana10, Sanchez Juan F.10, Sandborn Joy10, Sarap Michael D.10, Sarap Michael10, Sasaki Jennifer10, Schallenkamp John M.10, Schilder Lawrence E.10, Schlesinger Kimberly W.10, Scholl Jackie10, Scoppetuolo Michael10, Scott Jeanie10, Sexton Will10, Seydel Anna10, Shackour Mazin10, Shah Apurva10, Shah Minal10, Sharif Suhail10, Shaw Camilla M.10, Shehata Andrew10, Shelton Charles H10, Shields Reve10, Shilad Sabrina10, Shively Eugene10, Shriner Michelle10, Siebentritt Joel R.10, Singhal Shyamali10, Sinha Shreya10, Sinha Suman10, Slotkin Jaime10, Smith Kaylene10, Smith Sarah10, Smith-Marrone Stephanie10, Sobel Lawrence D.10, Sobolewski Anna10, Sobolewski Robin10, Solomon Naveenraj10, Songy Tonya C.10, Sonnier Fran10, Sorenson Leslie10, Sorto Juan C.10, Souza Will10, Spector David M.10, Spigelman Zachary10, Steitz Barbara10, Stephens Clifford10, Stewart Sheelagh10, Stipec Gretchen10, Stith Brittany10, Street Holly10, Subramanian Janakiraman10, Sumrall Maria10, Sundermeyer Mark10, Syed Ali10, Szwerc Michael10, Tanner Laura10, Tatum Tracey10, Taveira Roxana10, Taylor Michael10, Taylor Julia10, Teal Christine B.10, Tello-Skjerseth Christina10, Terhaar Kenneth10, Terhar Margaret10, Thind Ravneet10, Thomas Kendra L.10, Thompson Nancy10, Thomson Carey C.10, Tieu Brandon10, Toke Madhavi10, Tomita Megumi10, Tomkovich Kenneth10, Tong Elisa10, Tothy Peter10, Tran Maria10, Travis-Soper Kay10, Trikha Gaurav10, Trikha Guarev10, Vasnani Raj10, Veeramachaneni Nirmal10, Veerapaneni Annabelle10, Ventura-Cullen Deanna10, Vester Dee10, Vinsky Julia10, Visioni Anthony10, Vlaminck Lindsay10, Wadhera Akhil10, Wagner Jamie10, Waits Brandy10, Walenga Sharon10, Walker Michael10, Wallace Lucy B.10, Wallace James A.10, Ward Marie10, Warmington Kirsten10, Wasley Richard10, Watson Kimberly L.10, Watson Wendy10, Waxman Jonathan10, Weathersby Robert10, Weaver Elizabeth A.10, Weber Mary E.10, Weiselberg Christine10, Wesen Cheryl10, Wexler Ann10, Weyer Darlene10, White Paul10, White Christina10, Whitefield Karolina10, Wilkinson Reagan10, Willey James C.10, Williams Verneetta10, Wilson Jason P10, Witt Virginia M.10, Wold Howard10, Woodford Deb10, Woomer Scott10, Wray Justin W.10, Yeh Karen10, Yoon-Flannery Kahyun10, Zera Richard10, Zlomke Michael10, Zummo Kirby10, Zwicky Karen10,
Affiliation:
1. Northwestern University Feinberg School of Medicine, Department of Surgery, Chicago, Illinois 2. American College of Surgeons Cancer Programs, Chicago, Illinois 3. Markey Cancer Center, University of Kentucky, Lexington 4. National Accreditation Program for Breast Centers, Chicago, Illinois 5. Waterbury Hospital, Waterbury, Connecticut 6. American Cancer Society, Atlanta, Georgia 7. University of Nevada Reno School of Medicine, Reno 8. NorthShore University Health System, Evanston, Illinois 9. Now with GRAIL, LLC 10. for the Return-to-Screening Quality Improvement Collaborative
Abstract
ImportanceCancer screening deficits during the first year of the COVID-19 pandemic were found to persist into 2021. Cancer-related deaths over the next decade are projected to increase if these deficits are not addressed.ObjectiveTo assess whether participation in a nationwide quality improvement (QI) collaborative, Return-to-Screening, was associated with restoration of cancer screening.Design, Setting, and ParticipantsAccredited cancer programs electively enrolled in this QI study. Project-specific targets were established on the basis of differences in mean monthly screening test volumes (MTVs) between representative prepandemic (September 2019 and January 2020) and pandemic (September 2020 and January 2021) periods to restore prepandemic volumes and achieve a minimum of 10% increase in MTV. Local QI teams implemented evidence-based screening interventions from June to November 2021 (intervention period), iteratively adjusting interventions according to their MTVs and target. Interrupted time series analyses was used to identify the intervention effect. Data analysis was performed from January to April 2022.ExposuresCollaborative QI support included provision of a Return-to-Screening plan-do-study-act protocol, evidence-based screening interventions, QI education, programmatic coordination, and calculation of screening deficits and targets.Main Outcomes and MeasuresThe primary outcome was the proportion of QI projects reaching target MTV and counterfactual differences in the aggregate number of screening tests across time periods.ResultsOf 859 cancer screening QI projects (452 for breast cancer, 134 for colorectal cancer, 244 for lung cancer, and 29 for cervical cancer) conducted by 786 accredited cancer programs, 676 projects (79%) reached their target MTV. There were no hospital characteristics associated with increased likelihood of reaching target MTV except for disease site (lung vs breast, odds ratio, 2.8; 95% CI, 1.7 to 4.7). During the preintervention period (April to May 2021), there was a decrease in the mean MTV (slope, −13.1 tests per month; 95% CI, −23.1 to −3.2 tests per month). Interventions were associated with a significant immediate (slope, 101.0 tests per month; 95% CI, 49.1 to 153.0 tests per month) and sustained (slope, 36.3 tests per month; 95% CI, 5.3 to 67.3 tests per month) increase in MTVs relative to the preintervention trends. Additional screening tests were performed during the intervention period compared with the prepandemic period (170 748 tests), the pandemic period (210 450 tests), and the preintervention period (722 427 tests).Conclusions and RelevanceIn this QI study, participation in a national Return-to-Screening collaborative with a multifaceted QI intervention was associated with improvements in cancer screening. Future collaborative QI endeavors leveraging accreditation infrastructure may help address other gaps in cancer care.
Publisher
American Medical Association (AMA)
Cited by
11 articles.
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