Phase 3: Evaluate Assessment Data
Field Guide for Assessing Readiness to Implement Evidence-Based Cancer Screening Interventions
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Why Phase 3 Matters
Evaluating your assessment data will help you develop an implementation planning summary for the evidence-based interventions (EBIs) each clinic will implement or enhance. CDC requires Colorectal Cancer Control Program (CRCCP) recipients to develop this summary.
Phase 3 Activities
Complete these activities to evaluate your readiness assessment.
3.1 Calculate the Baseline Screening Rate
3.2 Evaluate the Workflow for Each Screening Test
3.3 Examine How Each EBI Is Being Implemented
3.4 Determine If the Implementation Approach Aligns with EBI Planning Guides
3.5 Identify IT Challenges That Impede Workflows and Data Reporting
“We thought together with our partners about work that needed to be done so they could effectively implement the EBIs. At the same time, we had to consider what would be sustainable. Our readiness assessment findings then provided the foundation of the clinic’s implementation plan.”
3.1 Calculate the Baseline Screening Rate
CDC requires recipients to report the baseline colorectal cancer screening rate when a clinic is recruited, and annually thereafter. CDC provides detailed guidance on how to measure the screening rate in its Guide for Measuring Cancer Screening Rates in Health System Clinics. This CDC resource also provides information on how to validate screening rates. Please refer to it when calculating the screening rate for a clinic.
3.2 Evaluate the Workflow for Each Screening Test
Evaluate the clinical workflow for each colorectal cancer screening test the clinic uses, such as stool tests and colonoscopy referral. As you assess the workflow, document the strengths, gaps, and opportunities. Consider each of the following workflows:
Screening Information Workflow
- How, when, and by whom are patients referred for each screening test?
- How and where are screening results documented?
- Who has access to that documentation?
Colorectal Cancer Screening Scheduling Workflow
- Who schedules screening, when, and how?
- How are appointments communicated to patients?
- Are there appointment reminders?
Colorectal Cancer Screening Test Results Workflow
- How is information communicated between clinics?
- Where, how, with whom, and when are results documented?
The New Hampshire Colorectal Cancer Screening Program’s Office Flow Assessment Approach and the Illinois Colon CARES Clinical Workflow Visualization provide examples of how two CRCCP recipients have documented and evaluated workflow assessments. The CRCCP Manual (Part 1, including Appendix B) also includes information to help you conduct a workflow assessment. The CRCCP Manual is available only to CRCCP recipients.
3.3 Examine How Each EBI Is Being Implemented
In their CRCCP Baseline Data Reports, clinics are required to document which EBIs they are implementing. CRCCP logic models — available in the CRCCP Manual (Part 1, Chapter 2) — provide example activities for each priority EBI that can help you assess how they are implemented. These logic models illustrate how EBIs can help achieve program goals and improve screening outcomes. The CRCCP Manual is available only to CRCCP recipients.
3.4 Determine If the Implementation Approach Aligns with EBI Planning Guides
The purpose of this activity is to determine if EBIs are implemented well. If an EBI is in place, but screening rates are not increasing, it may be due to poor implementation. Compare the actual implementation of EBIs in the clinic to CDC’s EBI implementation guidance, including the logic models found in the CRCCP Manual and Evidence-Based Intervention Planning Guides. The guides help public health practitioners guide implementation of recommended EBIs.
CDC’s logic models and EBI Planning Guides will help you use your assessment data to determine how well EBI components and delivery match the EBI definitions, and to determine if activities meet the criteria to be EBIs. They may also help you plan to enhance EBIs that clinics are already implementing.
If your assessment determines the clinic does not have the capacity to implement EBIs, you could consider this partnership later when the clinic is in a better position to focus efforts on EBI implementation.
3.5 Identify IT Challenges That Impede Workflows and Data Reporting
Effectively implementing and monitoring EBIs and documenting accurate screening rates rely on integrating health information technology (IT) into the clinical workflow. Therefore, identifying and resolving challenges facilitates improved implementation and increased screening rates.
3.6 Summarize the Assessment Results in Writing
Summarizing the results of your assessments in writing will help you complete the Clinic Implementation Planning Summary required by CDC. Tools to complete the planning summary can be found in the CRCCP Manual (Part 1, Appendix C: Clinic Implementation Planning Summary). The CRCCP Manual is available only to CRCCP recipients.