At a glance
In Phase 3, we provide resources to guide your collaborative efforts to interpret the data collected in Phase 2.
Why Phase 3 matters
Evaluating your assessment data will help you develop an implementation planning summary for the evidence-based interventions (EBIs) that each of your partner clinics will implement or enhance. CDC requires Colorectal Cancer Control Program (CRCCP) award recipients to develop this summary.
This is Phase 3 of the Field Guide for Assessing Readiness to Implement Evidence-Based Cancer Screening Interventions.
Phase 3 activities
Complete these activities to evaluate your readiness assessment.
CRCCP Award Recipient Insight
3.1 Calculate the baseline screening rate
As a CRCCP recipient, you must report baseline colorectal cancer screening rates when partner clinics are recruited and then annual rates thereafter. CDC provides detailed guidance on how to measure screening rates 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 sample 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 direct 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 how to enhance EBIs that clinics are already implementing.
If your assessment determines that a clinic does not have the capacity to implement EBIs now, you can consider partnering with this clinic later when it does have the capacity.
3.5 Identify IT challenges that impede workflows and data reporting
Effectively implementing and monitoring EBIs and documenting accurate screening rates require the ability to integrate health information technology (IT) into the clinical workflow. Identifying and resolving any IT challenges will improve implementation and potentially increase 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.
Frequently asked question
What if clinics disagree with the readiness assessment findings?
The readiness assessment process should reflect a collaborative effort between you and your clinic partners. Discuss the assessment data openly and address any differences in interpretations. Consider and discuss what factors might contribute to the differences. Determine if additional data are needed. If you are unable to agree on the assessment findings through team discussion, reach out to your CDC program consultant, who can provide additional insight and resources.