If you find that you have made significant improvement in increasing the CRC screening among your patients, you are to be congratulated. But this is not always the case when implementing quality improvement initiatives. If you determine that your office practice has not achieved your established goals for improving care of CRC screening, do not be discouraged. It often takes much longer than three months to achieve significant improvements.

To satisfactorily complete this module, it is not a requirement that your post-assessment results be higher than your pre-assessment results. However, if your results for post-assessment did not improve, you may want to ask yourself why you were not able to achieve the success that you had envisioned when you selected your interventions and implemented your CRC screening QIP. You may want to consider the following:

  1. Did you try to make changes on a small scale with a few patients to see if the changes worked before implementing on a broad scale? Very often, better ways of implementing a change are identified during small tests of change. This is a recommended technique to use when you implement an office system change.
  2. Were the practice change(s) you selected actually implemented? If not, why? Making improvements and sticking with change is difficult for most of us. Unless the new way of doing things is easier, we tend to fall back on our old comfortable patterns. To prepare for a smooth implementation of a change, it is wise to include all the staff that will be involved, identify barriers, and make plans to overcome the barriers.
    It is important to recognize that change, even when desirable, is stressful. Most people appreciate and need recognition for their performance. Extra effort by staff should be recognized even though it may not be easy for a busy practice.
  3. If the practice change(s) were implemented, were there glitches that prevented achieving desired outcomes? If so, could these be tweaked so new changes would be more effective? It may not be necessary to “throw out the baby with the bath water.” It may still be possible to attain improvement if the change you introduced can be modified.
  4. Do you want to implement other changes in your office practice that you think will improve CRC screening? You may choose to do this, regardless of whether or not your previous intervention strategies were successful. If so, you will want to go back to the Pre-assessment Interpretation of Results section, select another intervention, and implement a new QIP.

We have included references and links to quality improvement resources, as well as education and tools on CRC screening within the module . We encourage you to use these to generate new ideas and further enhance the patient care your office provides. We also encourage you to review the American Cancer Society's toolkit How to Increase Colorectal Cancer Screening Rates in Practice to learn more about how you can improve screening rates in your practice.