2021 Return-to-Screening ACS quality improvement project: Increasing mammography screenings post-COVID at UMass...

The COVID-19 pandemic significantly disrupted routine cancer screenings across the United States, including mammography services. UMass Memorial Medical Center experienced a 15.5% decline in screening volumes, prompting participation in the American College of Surgeons 2021 Return-to-Screening initiative to restore and enhance breast cancer-screening rates. The primary objective was to increase monthly mammography screening rates by at least 10% over pandemic-era levels, returning to or exceeding prepandemic volumes. The secondary objective was to provide earlier detection of breast cancer, and subsequent interventions.

A multidisciplinary team implemented a series of structural, operational, and outreach strategies between April and November 2021. Interventions included redesigning waiting areas for infection control, deploying bilingual digital communications, enhancing scheduling systems, engaging a Nurse Navigator, and launching the Simply Women marketing campaign. Clinics demonstrating lower performance were identified and provided with targeted education and data-driven support. The primary outcome measure was the monthly mammogram completion rate, compared pre- and post-intervention using data from UMass Memorial Medical Center's internal database.

During the implementation phase (June-November 2021), mammography rates increased by an average of 16.5% compared with pandemic-era levels. A 5-month period (April-August 2021) saw an 80% increase in screenings, with an additional 100 screenings per month achieved at peak. In the month of August 2021, our screening numbers reached 1751, which when compared to the month of April (974), represented an 80% increase. Secondary benefits included improved cross-departmental collaboration, increased provider engagement, and enhanced patient trust and compliance.

UMass Memorial Medical Center's initiative successfully restored and exceeded prepandemic screening volumes through a coordinated, data-informed, operations-driven strategy that emphasized accurate identification of high-risk patients using Breast Imaging-Reporting and Data System codes and a patient-centered approach. The model is scalable and may inform similar efforts in other institutions. Sustained collaboration with public health partners will support ongoing progress and equity in preventive care delivery.