Alleviating the click fatigue on clinicians to improve referrals for colorectal cancer screening.

Authors

null

Robby Amin

Horizons: South Georgia's Cancer Coalition, Albany, GA

Robby Amin , Lorriane Achieng Odhiambo , Sayeda Ali , KM Islam , Joycelyn W Yates , James Hotz , Koosh Desai , Cynthia George , Katreena Mitchell , Lynn M. Durham , Sheryl G. A. Gabram , Jorge Cortes

Organizations

Horizons: South Georgia's Cancer Coalition, Albany, GA, Institute of Public and Preventive Health at Augusta University, Augusta, GA, Albany Area Primary Health Care, Albany, GA, Phoebe Putney Memorial Health, Albany, GA, Georgia Center for Oncology Research and Education, Atlanta, GA, Georgia Cancer Center, Augusta, GA

Research Funding

Other Government Agency

Background: The impact of clinician burnout on patient care is pervasive across medical delivery systems. The effects are also felt in preventive care where cancer screening efforts rely on clinician referrals through the electronic medical records (EMRs). Though designed to support healthcare, EMRs are a significant source of clinician burnout given the number of clicks or navigation time needed to refer a patient. This is a barrier to Patient Navigation (PN) when ordered tests do not materialize into screenings or when clinicians order labs/imaging and the pending orders are not created. This causes frustration for all clinical staff involved, delays the workflow processes, and leads to missed opportunities for PN. We implemented an ‘order set’ intervention to reduce the click burden linked to colorectal cancer (CRC) screening referral among clinicians in South Georgia. Methods: The ‘order set’ intervention was developed to facilitate PN for a Colorectal Cancer Control Program (CRCCP) aimed at implementing Evidence-Based Interventions to increase CRC screening rates in Georgia. The ‘order set’ was designed to address workflow issues by consolidating steps associated with CRC screening. This reduced typing input and the need to click between multiple windows within the EMR while making a referral to PN. The intervention was piloted in the Albany Area Primary Health Care (AAPHC) system after modifications were made to the EMR and clinician workflows. The monthly CRC screening rates continue to be generated and tracked post-implementation. Results: The use of the ‘order set’ reduced the click burden from 78 to 7 inputs and clinician EMR interaction time from 110 seconds to 29 seconds. Providers from 4/7 clinics have adopted the ‘order sets’ when making referrals for CRC screening. Two clinics provided post-implementation screening data. The pre-implementation screening rates for one clinic were comparable (August = 59.3%, September = 57.6%) to post-implementation (October = 56.3%, November = 56.6%, December = 57.2%), while the second clinic showed some increase (August = 58.6%, September = 60%) vs. (October = 61%, November = 62.1%, December = 62.8%). Conclusions: The ‘order sets’ intervention reduced the time clinicians spent creating referrals for CRC screening, including fecal immunochemical tests (FIT) and colonoscopies. Additional follow-up and rollout to clinics participating in the program is underway to evaluate further the impact of the order sets on CRC screening outcome and process measures, including qualitative interviews with clinicians. There is significant potential in the application of order sets to various workflow processes to aid in preventative health efforts. Challenges linked to the COVID-19 pandemic and staff turnover affected acquisition of patient referral data.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Professional Development and Education Advances

Track

Medical Education and Professional Development

Sub Track

Clinician Burnout and Wellness

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 11021)

DOI

10.1200/JCO.2022.40.16_suppl.11021

Abstract #

11021

Poster Bd #

212

Abstract Disclosures

Similar Abstracts

Abstract

2024 ASCO Annual Meeting

Cost effectiveness of colorectal cancer screening in the Dominican Republic.

First Author: Yoanna S. Pumpalova

Abstract

2024 ASCO Gastrointestinal Cancers Symposium

Impact of revising colorectal cancer screening guidelines on health care resources in Canada.

First Author: Brendan Chia

First Author: Derek W. Ebner

First Author: Joshua Ling