Focus Area: Follow-up and Referral for Additional Testing and Treatment
Cervical 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 cervical 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
Implement best practices for notification of abnormal test results and follow-up instructions to the patient.
- Evidence-Based Cancer Control Programs – Fox Chase Cancer Center — Tailored Communication for Cervical Cancer Risk – Program Materials
- ONC — SAFER: Self-Assessment Test Results Reporting and Follow-Up [PDF-3.6MB], pages 5–7
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 – Cervical 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
Develop tracking systems to document when patients are due for their next regular screening.
- Good Samaritan Health Center — Tracking Abnormal Cervical Cancer Screening Follow-Up [PDF-716KB]
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.