Using the PDCA Model to Using the PDCA Model to Improve Cervical Cancer Improve Cervical Cancer ScreeningScreening

Dana D. HinesMarion County Health Department

Indianapolis, IN2009

Project GoalProject Goal

Improve cervical cancer screening rates at an HIV clinic

MethodsMethods

Surveyed HIV clinic staff and HIV positive women to identify strategies that would increase access and adherence to cervical cancer screening.

Collected cervical screening HAB data from June 1, 2008-June 1, 2009.

ResultsResults

Of the 155 who received a medical visit, only 4% had documented cervical cancer screening.

ResultsResults

Date of last PAP

01020304050607080

0-12 months 2-4 years 5-7 years 8-10 years unknown

Years

Perc

enta

ge

0-12 months 2-4 years 5-7 years 8-10 years unknown

Discussion of ResultsDiscussion of Results

The high percentage of women reported as “unknown” may indicate an issue with lack of documentation in the electronic medical record (Lab Tracker).

Strategies to Improve ScreeningsStrategies to Improve Screenings

Clinic Staff Improvement Ideas

0

1

2

3

4

5

6

Incl

ude

with

HIV

clin

icvi

sit

sam

e da

yor

wal

k-in

scre

eing

s

Pat

ient

educ

atio

n

Rem

inde

rca

lls/le

tters

Edu

catio

nal

mat

eria

ls

Cro

ss-

train

ing

HIV

staf

f

Co-

loca

ted

GY

N c

are

prov

ider

Insu

ranc

eco

vera

ge

Strategies

Freq

uenc

y

Staff Ideas

Strategies to Increase AccessStrategies to Increase Access

Patient Ideas

Patient Ideas for Increasing Access

12%

12%

6%

18%

52%

TransportationassistanceNurse education

Not being scared

Annual reminders

Screening on same dayas clinic visit

DiscussionDiscussion

Strategies identified by clients and staff and implemented at clinic:– Annual reminders– Educational brochures in waiting and

exam rooms.– Education for clinic staff regarding how

and where to document cervical cancer screening in Lab Tracker.

Future Ideas for ImprovementFuture Ideas for Improvement

Cross-train staff at HIV clinic to perform gynecological and related exams.

Partner with a gynecological provider that is co-located to the HIV clinic.– Offer cervical cancer screenings on

same day as HIV clinic visit.