ASSESSING THE IMPACT OF PRACTICE IMPROVEMENT TRAINING

1. ASSESSING THE IMPACT OF PRACTICE IMPROVEMENT TRAINING NIRMA KHATRI, BA, BS LISA ULMER, MSW, ScD HAMAD SINDHI, MPH OCTOBER 5, 2010 Drexel University School of Public Health

2. ABSTRACT • Objective(s): Pennsylvania has colorectal cancer incidence and mortality rates higher than the national average, and one of the lowest screening rates among all the states in the US. Literature indicates that primary care providers can play a critical role in statewide systems change to increase screening through: 1) Provider recommendations; 2) Office Policy; 3) Reminder System and 4) Communication Strategies. Toolkits and trainings to promote colorectal cancer screening among primary care providers are available, but it is not clear whether providers are able to translate the knowledge learned in training to practice. The purpose of this project is to develop a method for evaluating colorectal cancer screening practice improvement training for primary care providers. • Method(s): Evaluation tools were developed through a literature review of best practices for evaluating provider education • Result(s)/finding(s): Evaluation tools were concept-tested with a group of experts to assess both content and feasibility of administration. The final set of tools are presented and discussed. • Conclusion: The evaluation tools developed and tested in this project may be utilized to assess the impact of provider education, and improve provider education as needed, thus contributing to increased colorectal cancer screening at provider practices.

3. CONTENT • Importance of colorectal cancer screening training for primary care providers • Best practices for primary care provider training • Tools to evaluating practice improvement training • Assessing the impact of the practice improvement training • Next Steps

4. KEY ELEMENTS OF COLORECTAL CANCER SCREENING TRAINING FOR PRIMARY CARE PROVIDERS • Colorectal cancer (CRC) • Risk factors • Prevention strategies • Control strategies • Magnitude of the problem • Consequences of the issue • Major determinants to CRC screening

5. MAJOR DETEMINANTS OF COLORECTAL CANCER SCREENING Environmental: Access to primary care, screening procedures Social: Health insurance status and type, Socioeconomic status, Ethnic differences among provider and patient Psychological: Fear and Discomfort Individual: Knowledge and Socioeconomic Status

6. EVALUATING PRACTICE IMPROVEMENT • How will the system change be measured? • How were surveys developed? • Main components of the training

7. LEARNING ACTIVITY AND RETENTION Source: Ulmer & Fleisher, ACHI Conference, March 2008

8. DEVELOPMENT OF EVALUATION TOOLS • Measurement table • Surveys • Concept testing • Evaluation tool improvements

9. MEASUREMENT TABLE

10. SURVEYS: BASELINE, PRE/POST TEST

11. FINALIZATION OF EVALUATION TOOLS • Concept testing with panel of experts • Evaluation tool improvement

12. CONTRIBUTIONS TO PUBLIC HEALTH PRACTICE • The practice improvement training can be disseminated to other practices to increase screening rates as provider recommendation plays a key role in patient decision to screen • A dollar spent in screening saves three dollars in treatment • Screening helps identify the disease at the treatable phase • Thus, increasing screening rates will improve the health conditions and increase life expectancy

13. NEXT STEPS IN RESEARCH • Has practice improvement trainings led to increase in screening? • If not, what were some of the barriers in the implementation? • Was practice improvement training successful in changing the patient attitude, beliefs and intentions? • Were the implemented improvement in the practice improvement training successful in producing the results ?

14. THANK YOU!!! For further information, please contact Nirma Khatri at nirma.khatri@drexel.edu