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BACKGROUND/RATIONALE:
Colorectal cancer (CRC) is the second leading cause of cancer death in the US, and screening to allow early detection and prevention of CRC substantially reduces CRC mortality. The importance of optimizing CRC screening in VHA has been highlighted by recent research indicating the CRC screening is only current in 32% of age-eligible veterans. At many VA facilities, options for CRC screening are substantially limited by the availability of endoscopists. For example, until recently, Ann Arbor VA patients at average CRC risk were not considered eligible for primary screening sigmoidoscopies or colonoscopies due to excessive backlog; screening was thus restricted to fecal occult-blood testing (FOBT). Recent studies by the CRC QUERI have found similar issues in other VA facilities. In a recent national directive, the Department of Veterans Affairs stated that “Given that each [screening] modality has advantages and disadvantages and that none has clearly been proven to be superior, the choice of specific screening strategy needs to be based on patient preferences.” The directive has mandated that all screening options be allowed for patients, based on individual preferences. While this is an admirable goal, it is currently unclear whether a patient preference driven strategy is feasible due to staffing and resource limitations; planning to meet possible demand for endoscopy is clearly necessary.
OBJECTIVE(S):
We propose a QUERI study to estimate endoscopy demand and staffing needs in VHA. This project will build upon several QUERI projects that will provide critical data inputs for a simulation model projecting endoscopy demand. The specific aims of the project are as follows:
1) To project demand for CRC screening related endoscopy
2) To estimate staffing needs to meet projected demands for CRC screening
3) To create a flexible tool that can be used by facility managers to project local staffing needs and to help plan to meet demand for endoscopic services
METHODS:
We will use a previously published simulation model, along with aggregate reports of surveys of veterans, to estimate likely demand for various endoscopic procedures related to CRC screening in VHA. We will also examine, based upon CRC QUERI estimates, the current and projected staffing requirements to meet the national directive towards allowing a broader range of screening modalities than is currently applied. This will guide the VHA in setting policy for screening recommendations for CRC.
FINDINGS/RESULTS:
No results at this time.
IMPACT:
Not yet available.
PUBLICATIONS:
None at this time.
DRA:
Chronic Diseases, Health Services and Systems
DRE:
Quality of Care
Keywords:
Cancer, Patient preferences, Screening
MeSH Terms:
none
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