Increasing cervical screening rates at your practice

What is the aim of this QI activity 

The aim of this QI activity is to increase:

• education and awareness of CST  

• Improve the rates of CST within your practice. 

By participating in this quality improvement mini activity, your practice will be contributing to the national goal of eradicating cervical cancer as a public health problem in Australia by 2035 (ACPCC, 2023).

What will I need to do?

Follow the below 10 steps to improve your CST rates at your practice.

How will I complete this activity?

• Step 1: Form a quality improvement team

• Step 2: Review the National Cervical Screening Program

• Step 3: Order Resources & promote on social media (optional)

• Step 4: Integrate your Clinical Software with the National Cancer Screening Register (NCSR) and/or log in to the Healthcare Provider Portal

• Step 5: Identify eligible and overdue patients

• Step 6: Cross check your overdue list in the NCSR Hub or Healthcare Provider Portal

• Step 7: Remind patients using a targeted and opportunistic approach

• Step 8: Review procedure for inputting results

• Step 9: Track your improvements

• Step 10: Reflect on your efforts & consider future activities

Where do I document my results?

You can choose to track your results in a variety of ways including: 

• Cervical screening target poster 

• Quality Improvement register 

• Manually recording your numbers at the start and end of the activity

You may also choose to create your own way to track your results to best suit your practice if more suitable.

Who can I contact for support?

For support with this activity please contact the General Practice Quality Improvement team on Ph. 38647540 or email support@bsphn.org.au.

1. Form a quality improvement team

All staff can be involved and contribute in some way to this activity. Consider involving the Practice Manager, Administration Team, Nursing Team, General Practitioners. You might like to have a team meeting to brainstorm and decide on roles and responsibilities.

2. Ensure your clinical staff are familiar with the National Cervical Screening Program

Review the National Cervical Screening Program by reading the Healthcare Provider Toolkit: National Cervical Screening Program – Healthcare provider toolkit | Australian Government Department of Health and Aged Care

3. Order Resources & promote on social media (optional)

The Communications Toolkit  Cervical Screening Communications Toolkit | Australian Government Department of Health and Aged Care contains links to order resources such as posters, infographics as well as brochures to hand to patients. Consider your patient population when ordering resources, such as languages other than English. There are also plenty of ideas for social media posts. 

The new ‘Own It’ campaign includes resources targeting under screened groups. The kit includes social media tiles, newsletter content, email signatures and scripts if you wanted to create your own content! 

4. If your practice has not already done so, integrate your Clinical Software with the National Cancer Screening Register (NCSR)

The integration is available for BP Premier, MedicalDirector and Communicare. 

• Instructions for integration are available: Clinical Software Integration | National Cancer Screening Register

If this is not possible for you, you can view patient screening history via the Healthcare Provider Portal. The online Healthcare Provider Portal provides the same functionality as the NCSR integration in your clinical software. It is another avenue for health professionals to access and submit screening data electronically in the National Cancer Screening Register. Healthcare Provider Portal | National Cancer Screening Register

Technical support: If you require assistance in accessing the healthcare provider portal or integrating your clinical software, call 1800 627 701 to speak to a member of the Telstra Health Contact Centre, or you can book in a time to receive a call back: NCSR: Registration Help

5. Identify eligible and overdue patients

Start by using either of the below reports in Primary Sense to assist with identifying eligible and overdue patients.

1) Patients missing PIP QI or accreditation Measures.

 This report allows you to view active patients who do not have a cervical screening result on file for the previous 5 years.  

2) Patients booked in with missing PIP QI measures.

This report allows you to view active patients with upcoming appointments in the next 2 weeks who do not have a cervical screening result on file for the previous 5 years. 

6. Cross check your overdue list in the NCSR Hub or Healthcare Provider Portal 

If your patient has gone to another provider for their cervical screening test, your practice may not receive the result and therefore the patient may be showing as overdue in your system. To avoid the patient being sent a reminder, you can cross check your overdue list with the NCSR Hub or Healthcare Provider Portal. 

Update your patients’ cervical screening history within the relevant section of their file in your clinical software (refer to step 8 for instructions). If they are overdue, ensure the patient is followed up for screening.

7. Remind patients using a targeted and opportunistic approach

You can choose to send screening reminders to the patients identified in the reports above, if they are due or overdue. Consider sending an SMS or phoning the patient (In line with your privacy policy & handling of patient information) Example:

1) Overdue/Never Screened:

‘Hi ____A Cervical Screening Test every five years is the best way to prevent cervical cancer. Our records indicate that you are overdue. The test can be completed by the Doctor/Nurse or by self-collection here at the Practice. To book.... Dr XXX’

2) Invitation for 25-year-olds:

‘Hi ____Turning 25 means you’re due for cervical screening. A Cervical Screening Test every five years is the best way to prevent cervical cancer. The test can be completed by the Doctor/Nurse or by self-collection here at the Practice. To book.... Dr XXX’

For patients with an upcoming appointment in the next two weeks, consider placing a note in the appointment calendar as a prompt for the Nurse or Doctor to discuss Cervical Screening with the person. 

8. Review procedure for inputting results

Ensure all Health Professionals that perform and review cervical screening results are including the result into the clinical software Cervical Screening tab. This helps to ensure your data in Primary Sense is an accurate reflection of your efforts.

Example for Best Practice: Bp-Summary-Sheet-Enter-Cervical-Screening-Test-CST-Result-Train-IT-Medical-V03-2017.pdf

MedicalDirector:MD-Summary-Sheet-Enter-Cervical-Screening-Test-CST-Result-Train-IT-Medical-V03-2017.pdf

9. Track your improvements 

To measure your progress throughout this self-paced activity and determine whether your changes have resulted in an improvement, you can  use Primary Sense to monitor the number of patients who are eligible or overdue for cervical screening.

Use the below Primary Sense report:

PIP QI report - 10 measures report

This will show the number of eligible active patients that have an up-to-date cervical screening result in file as a percentage (%). As you progress through your activity, this number should increase due to increased numbers of patients with an up-to-date cervical screening test, or through the improvement of accurate patient records due to your use of the NCSR hub.

Write your percentage on your target poster at the start of the activity and review it at the end of the month. 

Start of project = 

End of project =

10. Reflect on your efforts & consider future activities

At the end of the month reflect on the activity as a team. Some questions to prompt team reflections are: 

1. Did you increase the percentage of active patients that have an up-to-date cervical screening result on file?

2. What have you learnt from the QI activity?

3. Have you developed any new processes? 

4. What were the challenges?

5. Celebrate your achievements! 

6. What would you like to do in the future? (See below!)

After this activity, you might like to work on something different. The HPV Vaccine and the Cervical Screening Test work together to prevent cervical cancer. You could focus on identifying patients who may have not completed their HPV vaccine schedule and inviting them to receive the vaccine. 

Learn more about the HPV vaccine here: HPV (human papillomavirus) vaccine | Australian Government Department of Health and Aged Care

Use this blank template to get started with Quality Improvement Activities: Brisbane South Primary Health Network: QI Tools and resources | Brisbane South PHN

Here is an example of a prefilled Cervical Screening PDSA Cycle: QI Toolkit Introduction