Who can see your viewing activity?
If everyone will please mute unless talking, thanks very much
hullt, you need to mute please.
I am at the hospital and subject to their power source-this has never happened before!
Samantha K Hendren
Even with risk adjustment (eg stage), there is variation is quality of care
that's not equity.
True, NCDB captures many important dates and publish "time to" metrics in a variety of ways. Some of our Quality Measures have those timing components, PUF files and CQIP...
We need more ideas about equity that we can probe in NCDB. This is rich resource and could tell us more about disparities- need your thoughts
If there is not different survival outcomes based on different acceptable times to care, if we emphasize time to care are we actually at risk of disserving our patients by suggesting they need to hurry to care rather than make a fully informed decision? Do we need to better educate our patients
Can we use the NCDB to identify sites who seem to have addressed equity well and learn from them?
From a data standpoints, we would need a consensus on what metric best measures equity
is it differentiated between patients who are due for their next screening broken down separately from patients who are NEW screening patients?
any reason melanoma screenings was not included?
skin cancer/melanoma screenings are not USPSTF "approved", so specific guidelines are not as solid as for other cancers
USPSTF = "i" for skin cancer
i = insufficient evidence to assess balance of benefit- harms
what is considered screening for CRC? Just c-scope or fecal tests as well. New USPSTF guidelines came out yesterday
We are asking folks to follow evidence-based guidelines, such as promoted by USPSTF, American Cancer Society or other sources. And yes to screening tests beyond just colonoscopy- including fecal tests
We are not differentiating between initial vs. follow-up screening. We wanted this project to require as little administrative/data collection effort as possible, so we are monitoring screening exam volume at the hospital level rather than abstracting data for individual patients. Although this will admittedly not give the same level of detail, we believe it will allow many more sites to participate.
Scott Kurtzman NAPBC
This was also an opportunity to teach centers how to do a good and modern QI project by modeling the PDSA technique. Not all centers had that skill.
At my institution we stopped screening for a very short time, but even if we had stopped for a year, since we do recommend annual mammograms, if the patient simply comes on the next annual anniversary, where is the number increase. Obviously more cancer should be detected due to the lapse, but more screens don't seem needed. This is totally distinct from colon cancer screening, given the longer interval.
This project is value added for programs.
finally still in you have a lapse, when you bring in the lost cohort, their new time of next screen is moved
Maybe one of the real risks is that during the pandemic people skipped any type of screening, and so will patients begin to devalue screening and not resume
Napbc..has a category of best pactice identified at site visit is one called overcoming a deficit...ant in rubber tree plant. we collect these.