NR 506 Week 3 Quality Healthcare: Measuring NP Performance
NR 506 Week 3 Quality Healthcare: Measuring NP Performance
Breast cancer screening (BCS) is one of the HEDIS measures under the domain of effectiveness of care. This measure evaluates women 50–74 years who have undergone at least one mammogram for breast cancer screening in the past two years (NCQA, 2022). The measure is significant because breast cancer is the most prevalent cancer among females in the US. BCS is considered to enhance outcomes since early breast cancer detection decreases mortality risk and reduces treatment costs. The purpose of this paper is to discuss patient interventions for BCS, including how they can improve patient outcomes, cost, and patient ratings.
Patient Interventions for Breast Cancer Screening
The proposed patient interventions to increase BCS are Health education sessions, Reminder-based interventions, and eliminating out-of-pocket mammogram costs. Health education sessions will aim at increasing individuals’ knowledge of the benefits of BCS and improving BCS uptake and behavior. Noman et al. (2020) found that previous studies on the efficacy of educational interventions established improved screening rates. The increased BCS uptake was fostered by multiple education strategies, multilevel interventions, culturally appropriate components, language-appropriate interventions, and personal and cognitive interventions.
The sessions in the primary care setting will include intensive in-person and group education in BCS and providing mammography educational materials. Women aged 45 years and older seen at the hospital will be screened for their risk of developing breast cancer and counseled on the importance of having BCS at least every two years. Patient education will be tailored to a patient’s culture, literacy levels, and learning preferences. Furthermore, educational materials will use simple English terms with pictures and charts to increase patients’ understanding. The intervention will be measured by evaluating BCS uptake in the hospital, especially among women educated on breast cancer.
Reminder-based interventions entail letters and telephone calls to remind women of their upcoming mammograms. Personalized reminder letters and telephone counseling increases individuals’ motivation for BCS, which promotes repeated mammography screening. Providing mammography reminders can increase the percentage of women receiving their first-time mammogram. Lin et al. (2020) found that more women came for mammography screening after getting reminder interventions. Telephone contact had the greatest influence over mail reminders. The article recommends healthcare providers implement the telephone reminder strategy to persuade women to have their first and subsequent mammography screening.
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The Reminder-based interventions will be implemented in the primary care setting by taking the contacts, emails, and postal addresses of women who are candidates for mammography. They will be sent personalized emails a week before their scheduled mammography dates to remind them of their BCS. In addition, they will be contacted via telephone to counsel them on BCS and remind them of their upcoming mammography. The outcome will be measured by evaluating the number of repeat mammography screenings, which is the number of women who undergo at least two consecutive on-schedule mammograms within two years.
Eliminating out-of-pocket (OOP) mammogram costs will seek to increase mammogram uptake by women. Tran et al. (2022) explain that even though cost sharing has been removed for screening mammograms, patients still encounter OOP mammogram costs, mostly for diagnostic and follow-up testing. OOP mammogram costs from baseline screening mammograms and follow-up testing are linked with lower chances of going through subsequent mammography screening. Tran et al. (2022) found out that for each $100 increase in the OOP costs for the baseline mammogram, the chances of subsequent screening in the next 12-24 months were reduced by 1.9 pp. The intervention will be implemented in the primary care setting by engaging in policy and legislation to have policies requiring insurance policies mandating all insurers to cover diagnostic and follow-up tests for mammograms. The intervention will be evaluated by assessing the number of insurance policies that cover all associated mammogram costs.
How the Primary Care Interventions Result In Improved Patient Outcomes and Cost Savings for the Practice
Health education interventions increase BCS among women. Agide et al. (2018) established that common health promotion interventions like individual-based, group-based, and community-based health education initiatives targeting women increased BCS. In addition, personalized reminders increase mammography uptake for initial and subsequent screenings. This improves patient outcomes since it helps to identify women with breast cancer in the early stage, and thus early treatment interventions are initiated, leading to a better prognosis. Besides, breast cancer treatment in the early stages is less expensive than when the disease has advanced, which usually requires more sophisticated treatment interventions. Champion et al. (2022) found that personal reminders increase follow-up after a positive breast cancer screen. Thus, this improves patient outcomes since patients with positive mammogram tests are initiated early on follow-up tests to confirm breast cancer as well as treatment interventions.
Eliminating OOP increases mammography utilization since patients are not subjected to additional expenses, thus lowering the cost of care. Tran et al. (2022) found that even a fairly small OOP spending requirement was linked with considerably reduced mammography rates among women 65 to 69 years. This, getting rid of OOP increases patient outcomes since more patients are followed up after the baseline mammogram, and the necessary treatment interventions are implemented.
How the Interventions Result In Improved NP Patient Ratings
The above interventions increase patient satisfaction with care which improves NP ratings. Tailored patient education sessions increase patients’ knowledge of the benefits of BCS, making patients make informed decisions regarding having mammograms. Patients are more satisfied when they understand why they are having a procedure and make a personal decision rather than when they feel coerced to undergo it (Noman et al. (2020). Furthermore, personalized reminders increase patients’ satisfaction with the services provided, which increases NP patient ratings. Reducing medical costs improve patients’ satisfaction with care. Therefore, eliminating OOP mammogram costs in NP practices can increase patient ratings.
Conclusion
Breast cancer is prevalent among American women, and BCS has been identified as a HEDIS measure to increase screening and early treatment. The proposed patient interventions to increase BCS are Health education sessions, Reminder-based interventions, and the Elimination of OOP mammogram costs. Health education seeks to improve patients’ understanding of the benefits of BCS and increase mammogram reuptake. Reminder-based interventions entail reminding patients of their upcoming mammograms to increase uptake and follow-up. Eliminating OOP costs will reduce healthcare costs and increase the uptake of subsequent mammograms after the baseline test.
NR 506 Week 3 Quality Healthcare: Measuring NP Performance References
Agide, F. D., Sadeghi, R., Garmaroudi, G., & Tigabu, B. M. (2018). A systematic review of health promotion interventions to increase breast cancer screening uptake: from the last 12 years. European journal of public health, 28(6), 1149–1155. https://doi.org/10.1093/eurpub/ckx231
Champion, V. L., Monahan, P. O., Stump, T. E., Biederman, E. B., Vachon, E., Katz, M. L., … & Paskett, E. D. (2022). The Effect of Two Interventions to Increase Breast Cancer Screening in Rural Women. Cancers, 14(18), 4354. https://doi.org/10.3390/cancers14184354
Lin, M. L., Huang, J. J., Li, S. H., Lee, F. H., Hou, M. F., & Wang, H. H. (2020). Effects of different reminder strategies on first-time mammography screening among women in Taiwan. BMC Health Services Research, 20, 1-8. https://doi.org/10.1186/s12913-020-4948-6
NCQA. (2022, June 3). Breast cancer screening. https://www.ncqa.org/hedis/measures/breast-cancer-screening/
Noman, S., Shahar, H. K., Abdul Rahman, H., Ismail, S., Abdulwahid Al-Jaberi, M., & Azzani, M. (2020). The Effectiveness of Educational Interventions on Breast Cancer Screening Uptake, Knowledge, and Beliefs among Women: A Systematic Review. International journal of environmental research and public health, 18(1), 263. https://doi.org/10.3390/ijerph18010263
Tran, L., Chetlen, A. L., Leslie, D. L., & Segel, J. E. (2022). Effect of out-of-pocket costs on subsequent mammography screening. Journal of the American College of Radiology, 19(1), 24-34. https://doi.org/10.1016/j.jacr.2021.09.028
