215699 Twists and Turns of Colorectal Screening: The Role of the Patient Navigator

Monday, November 8, 2010

Andrea Dwyer , University of Colorado Cancer Center, Aurora, CO
Susan Rein, RN, BSN , The Colorado School of Public Health, Aurora, CO
Andrea Masias, MS , The University of Colorado Cancer Center, Aurora, CO
Holly Wolf, MSPH, PhD , The Colorado School of Public Health, Denver, CO
Tim Byers, MD, MPH , Dept. of Preventive Medicine and Biometrics, University of Colorado Health Science Center, Denver, CO
The Colorado Colorectal Screening Program (CCSP) is a state wide program to provide endoscopic screening to low-income, uninsured Coloradans ages 50 to 64. The coordinating center at the University of Colorado Cancer Center partners with the primary care, safety net practices to implement the Program; as these institutions largely serve as the medical home for the medically underserved. The safety net partners with screening /treatment providers throughout Colorado to provide care for patients. Program components include: endoscopic screening, follow-up and treatment, patient navigation, and public awareness. Screening navigation is a key element of the Program, as the procedure requires prior cleansing of the bowel and sedation during the procedure. The screening navigator's role is to specifically educate patients about the procedure and reduce barriers. Since inception in 2006 to December 2009, CCSP screened over 9400 individuals. Approximately 26% of those screened had types of polyps removed that have potential of becoming cancer and 1% were diagnosed with colorectal cancer. The decision to base the screening patient navigator directly within the patient's medical home has resulted in vast improvements in adherence to the medical guidelines for screening and quality of care. Prior to Program implementation, safety net clinics reported low screening compliance rates and ‘no show' rates as high as 70% for referrals to screening. CCSP evaluation data demonstrate a no show rate of 12% and an adequate exam rate of 96%, which is dependent on good bowel preparation and education, both indicative of the success of the screening navigation.

Learning Areas:
Administer health education strategies, interventions and programs
Chronic disease management and prevention
Diversity and culture
Implementation of health education strategies, interventions and programs
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe the role of a patient navigator in prevention based programs like the Colorado Colorectal Screening Program.

Keywords: Prevention, Access to Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I lead the patient navigation faucet of the Colorado Colorectal Screening Program. I am one of the founding members of the Program and a key person in implementing the Program within the desigated safety net.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.