Enhancing equity and efficiency in cervical screening uptake: a multidisciplinary quality improvement initiative

Area of Science:

• Public Health
• Healthcare Quality Improvement
• Gynecologic Oncology

Background:

• Cervical cancer screening is crucial for early detection, but uptake is often suboptimal, particularly in diverse communities.
• Cauldwell Medical Centre faced low screening rates (54% for ages 25-49, 62% for 50-64) and a significant 8-percentage point age disparity, falling short of the 80% national target.
• Addressing these disparities is essential for equitable cancer prevention strategies.

Purpose of the Study:

• To implement and evaluate quality improvement (QI) methodologies to increase cervical cancer screening uptake.
• To reduce the disparity in screening rates between different age groups.
• To enhance the accessibility, trust, and personalization of cervical screening services.

Main Methods:

• Utilized Plan-Do-Study-Act cycles and statistical process control charts for iterative testing and refinement.
• Implemented eight cycles of change focused on three key areas: accessibility, trust, and personalization.
• Introduced interventions such as culturally sensitive outreach, extended clinic hours, and a self-booking system.

Main Results:

• Cervical screening uptake increased significantly: from 54% to 69% (ages 25-49) and 62% to 72% (ages 50-64) by March 2023.
• The age-related disparity in screening rates narrowed from 8 to 3 percentage points, a 60% reduction.
• By the final monitoring week, uptake reached 73% (ages 25-49) and 82% (ages 50-64), exceeding the national target in the older age group.

Conclusions:

• Systematic application of QI methodologies effectively addresses healthcare inequalities in cervical screening.
• The project demonstrates a scalable model for improving screening uptake among under-represented populations.
• QI initiatives can significantly enhance the effectiveness of existing healthcare services and reduce disparities.