Patient Screening and Workflow Process Optimization
The flowcharts and descriptions detail the steps involved in identifying eligible patients for screening, managing patient flow during visits, and tracking screening results. The process includes reviewing patient charts, determining screening eligibility, discussing screening options with patients, and ensuring proper follow-up for screening tests. The goal is to streamline the workflow for efficient patient care.
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Flowchart Template: Review Link to Learn How Start Process Process Decision No Yes Process End https://www.youtube.com/watch?v=GsfZD4oU7l0
Identifying Patients for Screening Nurse pulls list of patients aged 45-75 Describes process around identifying eligible patients, noting patients due for screening, notifying patients due for screening, and flagging files for providers Nurse reviews patient chart Has patient had a colonoscopy within the last 10 years? Yes Go to next patient No Has patient done a home stool test for CRC this year? Yes No Patient is considered high risk and does not qualify for take home test Leave note on chart for provider to discuss scheduling a colonoscopy Yes Hx of Crohn s Dx or Colitis? No Hx of polyps or CRC? Yes No Fam Hx of polyps or CRC in fam <60 y.o.? Yes No Nurse calls or sends a letter to patient notifying patient of due screening and need to schedule appointment Patient calls clinic to schedule appointment for screening Nurse puts note on chart for provider stating the need for home stool test
Patient Flow During Visit Include: Physical spaces and processes that take place for each Identify the availability of educational materials at each step Identify when and how CRC screening is discussed Identify staff responsibilities for ordering tests and for educating patient on how to complete the tests Registration staff update patient contact information and hand patient paperwork to complete Nurse rooms patient, completes health maintenance items and sees note for CRC test Patient arrives for visit Patient checks in with registration staff Nurse utilizes CRC screening algorithm to determine risk level Nurse ensures a note is on the chart to alert provider and lets provider know patient is ready and verbally confirms need for home stool test or colonoscopy Provider notifies patient they are due for their home stool test/colonoscopy Yes Provider conducts clinic visit with patient No Provider utilizes Exact Sciences Screening Option tear-off sheet to facilitate shared decision on the best test for the patient. Provider schedules patient for a colonoscopy and provides education for next steps Does patient require a colonoscopy? Yes End Nurse ensures patient does not have any other questions prior to leaving No Provider provides a home stool test with instructions and places an order in the chart Provider notifies the nurse the patient will complete the stool test at home
Screening and Results Tracking Include: Staff responsible for determining when a screening test has been completed or if a screening test is incomplete. How results are documented How patients are informed of results Provider or nurse puts order in chart for CRC screening test and makes appropriate referrals Test has been completed and resulted in the EHR Nurse sends letter to patient stating the test was negative and to follow up as usual with primary care provider Yes Was the test negative? Nurse reviews results No Provider/nurse calls patient with results and schedules follow-up appointment to discuss colonoscopy Nurse notifies the provider of positive results
Workflow for Follow-up Colonoscopy (following positive stool test) Include: Staff responsible for scheduling the follow-up colonoscopy Staff who reviews prep instructions with the patient What happens when patients are uninsured or underinsured Specialist provider referral processes Estimated wait times Patient has positive CRC home stool test and arrives for follow-up appointment Nurse asks patient if anything has changed related to stool health since last visit and documents Nursing team rooms patient and completes health maintenance items Reception staff confirm patient information Provider places referral for colonoscopy and communicates new order to nurse Nurse notifies provider patient is ready and communicates any changes Provider reviews stool test results and educates patient on next steps Provider answers any questions patient may have Does patient need to be referred out for test? Nurse determines if patient qualifies for NDCRCSI Referrals sent to appropriate locations Nurse reviews prep instructions with patient Yes No Patient, nurse, and schedulers work together to schedule colonoscopy test and estimate wait time for appointment Patient completes visit
