Focus Area: Follow-up and Referral for Additional Testing and Treatment
Breast Cancer Screening Change Package
The follow-up and referral focus area includes tools and resources to—
- Promote and support regular screening per USPSTF recommendations.
- Ensure timely referral for diagnostic testing, treatment, and other appropriate next steps, such as genetic testing, when screening tests are abnormal.
- Change concepts are “general notions that are useful for developing more specific strategies for changing a process.”1
- Change ideas are evidence-based or practice-based “actionable, specific ideas or strategies.”1
- Each change idea is linked to tools and resources that can be used or adapted to improve cancer screening.
Notes
- Tools and resources with a symbol may contain some information that does not reflect the current US Preventive Services Task Force (USPSTF) recommendations for breast cancer screening.
- Tools and resources with a symbol are patient resources.
See a list of acronyms used in this change package.
Change Concept: Establish relationships with specialists for diagnostic testing and treatment.
Tools and Resources, by Change Idea
Identify and partner with referral services or specialists who can provide follow-up diagnostic tests and/or cancer screening.
Establish two-way communication with referral services or specialists to find out if patients followed up with referrals.
Change Concept: Adopt policies and procedures for patient referral and follow-up for diagnostic testing and treatment.
Tools and Resources, by Change Idea
Develop protocols and workflows, such as reminder systems, to ensure follow-up referrals are made.
- Nekhlyudov L, Latosinsky S, 2010 — The Interface of Primary and Oncology Specialty Care: From Symptoms to Diagnosis
- The Primary Care Coalition of Montgomery County — Breast Healthcare Improvement in the Safety-Net: Change Package Rapid Innovation to Improve Outcomes [PDF-2.9MB]
Implement best practices for notification of abnormal test results and follow-up instructions to the patient.
Create a tracking system for documenting patient follow-up after an abnormal test result.
- ACOG — Tracking and Reminder Systems
- ECRI on behalf of HRSA — Using the EHR for Care Management and Tracking [PDF-696KB]
Use EHR-based clinical decision management tools to guide follow-up care.
- ECRI on behalf of HRSA — Using the EHR for Care Management and Tracking [PDF-696KB]
Change Concept: Overcome barriers to follow-up and treatment.
Tools and Resources, by Change Idea
Identify sources for low-cost or free transportation services for follow-up care.
- ACS — Road to Recovery [English and Spanish]
- AHA — Social Determinants of Health: Transportation and the Role of Hospitals [PDF-2.6MB]
- CMS — Non-Emergency Medical Transportation (NEMT)
- Livestrong — Transportation and Other Cancer Support Resources
Offer same-day and open-access scheduling and services outside of traditional hours.
- The Community Guide — Cancer Screening: Reducing Structural Barriers for Clients – Breast Cancer
Use patient navigation to help individuals access follow-up services.
Change Concept: Implement follow-up processes for regular screening.
Tools and Resources, by Change Idea
Provide visit summaries and patient education on future regular screening.
Reference
1Centers for Disease Control and Prevention. Tobacco Cessation Change Package. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2019.