Lung Cancer Screening Workflow Process Improvement Suggestions
| Lung Cancer Screening Component | Lung Cancer Screening Barriers | Workflow Process Improvement Facilitators |
|---|---|---|
| Patient Identification | Lack of adequate workflow systems & Patient non-adherence | Document tobacco use in the patient’s EHR; Use the EHR as an LCS patient identification tool via a checklist with the United States Preventive Services Taskforce guidelines; Use of a “huddle” sheet fastened to the exam room door to remind PCPs about preventive services with another staff member who could assure it gets completed |
| Referral | Lack of adequate workflow systems | Champions to help establish processes like thorough communication pathways between PCP referring clinic and radiology facility performing the low-dose CT scan via electronic health records, a shared online database, or scheduled phone calls |
| Screening | Lack of adequate workflow systems | Use the EHR or a database to track low-dose CT screening orders and missed low-dose CT scan appointments |
| Result | Lack of adequate workflow systems | Rely on flags in the EHR to follow-up with patients regarding their scan results; use of the “huddle” sheet to remind the PCP to discuss results |
| Patient Follow-up Post Screen | Lack of adequate workflow systems (Lack of support from clinic leadership) | Use the EHR or other database to track and monitor patients with abnormal screen results, ideally a database that has alerts and reminders embedded to create reports; Designate clinic staff to track and monitor patients post LCS |
| Patient Navigation | Transportation, cost, radiation exposure | Designate a patient navigator who is a member of the clinic staff to track and monitor all LCS patients from referral to post-screening follow-up, and can assist with patient needs; Use of mobile CT scanners, SDM interactions conducted via telehealth, increasing awareness of federal cancer centers, and round-trip transportation vouchers |
| Shared Decision-Making Tools | Health literacy & Impractical decision aids | Use shared decision-making tools, such as toolkits, decision aids, or information sheets, and web-based resources or apps |
Abbreviations: EHR, electronic health record; LCS, lung cancer screening; low-dose CT, low-dose computed tomography.
Note: Italicized portions indicate suggestions from the literature. Non-italicized portions indicate suggestions from our respondents.