Mammography Adherence: Creation of a Process Change Plan to Increase Usage Rates

Tara E. Smalls

Sue P. Heiney

Beverly Baliko

Abbas S. Tavakoli

mammography, adherence, process improvement, breast screening
CJON 2019, 23(3), 281-287. DOI: 10.1188/19.CJON.281-287

Background: Mammography is the optimal tool to mitigate breast cancer morbidity and mortality; however, in many healthcare settings, mammography adherence rates are decreasing.

Objectives: This nurse-led quality improvement project was conducted to improve patient adherence to annual mammography screening.

Methods: Data collection included clinical information from the electronic health record, chart reviews, tracking documentation used by the clinic’s social worker, interviews with staff, observation of the clinical setting, creation of a process flow map to identify barriers, and identification of internal and external resources. Strategies to reduce barriers included communication with staff about problems, a streamlined referral process, a scripted message about mammography, an up-front assessment of financial and social barriers to adherence, and an early referral to resources.

Findings: A pre–process change chart audit showed a 22% mammography adherence rate. The post–process change rate was 51%, representing a statistically significant difference in adherence.

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