QUALITY HEALTHCARE: MEASURING NP PERFORMANCE The National Committee for Quality Assurance (NCQA) was formed in 1990 with the goal of improving the quality of health care for millions of people (National Committee for Quality Assurance, 2020). The NCQA created HEDIS, a performance measurement tool, used by health insurance plans, to improve patient care and improve overall health (National Committee for Quality Assurance, 2020). HEDIS focuses on measures that can make a meaningful difference in patient’s lives (National Committee for Quality Assurance, 2020). One in eight women will be diagnosed with breast cancer during their lifetime and it is the second most common cancer among women (Susan G. Komen, 2020). The CDC recommends yearly or biannual mammography for patients between the age of 50-74 (Centers for Disease Control and Prevention, 2020). One HEDIS measure assesses the percentage of women within this age range who have had their recommended bi-annual mammogram (National Committee for Quality Assurance, 2020). The Nurse Practitioner as the primary care provider has an integral role in breast cancer prevention, detection, and treatment. In many cases, a patient’s primary care provider is the first to address concerns for cancer, including symptoms and risk assessment. In addition, the primary provider will continue to coordinate care with the breast cancer patient throughout their treatment, recovery, and beyond. In one year, there is an estimated 268,600 new cases of female breast cancer and 41,760 deaths attributed to breast cancer (Centers for Disease Control and Prevention, 2020). One of the greatest indicators for breast cancer survival is early detection (Centers for Disease Control and Prevention, 2020). Mammography is the only test shown to reduce breast cancer deaths due to their ability to detect cancer in early stages (National Cancer Institute, 2020). Following recommendations for mammography studies, can lead to better patient outcomes and increased chance of survival, as well as lower healthcare costs which lead to a successful practice (Susan G. Komen, 2020). As a primary care NP, implementing strategies to increase compliance with biannual mammography studies, is key to improving patient care while increasing the survival rate of breast cancer. Patient Interventions Intervention One: Patient Reminders One strategy to increase the number of patients getting their biannual mammogram is through patient reminders. A quality improvement project on breast cancer and mammography compliance in a primary care clinic, found that patients who were reminded of their need for a mammogram by phone, letters, and in-person care, were more likely to follow through with their tests (Kemper, 2019). By utilizing different ways to communicate with patients, the likelihood of getting vital information to them and stressing the importance of the information is reassured. Patients who are due to have a mammogram within 6 months charts could be flagged. Many electronic health record software’s have tools that can create patient reminders as well. This running list of patients allows the NP and other staff members to monitor which patients to contact. Data about how the patient was reminded, how many times the patient was reminded, and if they followed through with their mammogram or not can be collected and analyzed to see if the intervention was successful in increasing compliance with mammograms. Intervention Two: Mobile Mammography Units Another strategy to improving rates of mammography is through the use of a mobile mammography unit. Not only would mobile mammogram vans benefit the patients of the practice, but it could also influence the community as a whole. Mobile programs can reach urban
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