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October's HRSA Quality Improvement Grantee Spotlight

“West End Medical Centers’ Breast Cancer Prevention Programs”

West End Medical Center logo

In recognition of National Breast Cancer Awareness Month , HRSA’s Health Quality Improvement (QI) website spotlights the West End Medical Centers, Inc (WEMC). WEMC operates two successful, innovative, and expanding breast cancer prevention programs that focus on quality improvement activities for the safety net population they serve, many of which pertain to the following areas:

  • Conducting patient outreach and education events;
  • Use of Patient Navigators to help breast cancer patients;
  • Expanding age demographics of patients;
  • Use of both UDS and internal quality measures for improving quality.


WEMC’s breast cancer prevention program aims to reduce this disease’s impact among the underserved community within the greater Atlanta area. Breast cancer is the most prevalent form of cancer among women. In 2010, it is estimated that 207,090 women were diagnosed with breast cancer, and that 39,840 women died from this disease . Federally Qualified Health Centers (FQHC), like WEMC, play an important role in breast cancer prevention within the safety net community, and breast cancer screening is a mandatory Uniformed Data System (UDS) measure.   

West End Medical Centers and Their Breast Cancer Prevention Programs

Founded in 1976, the West End Medical Centers, Inc (WEMC) is a member of the Georgia Primary Care Association (PCA).  WEMC provides comprehensive health care services to the safety net population of the Greater Atlanta area.  WEMC focuses on disease prevention, early diagnosis and treatment, and serves more than 26,000 patients annually, generating more than 55,000 patient visits.

WEMC’s initial breast and cervical cancer program started 10 years ago providing services to women aged 50-64 years old. Later, WEMC’s services expanded to include women 40 years old and older. At the time, there were insufficient cancer prevention programs available for the underserved community in the greater Atlanta area. However, WEMC lacked the resources to provide mammography services necessary for breast cancer screenings. They bridged this gap by establishing a referral partnership with local hospitals and mammography services.  This referral relationship allows WEMC to appropriately coordinate the patient’s care both before and after a patient’s mammography.  WEMC  also provides assistance for patients with other barriers to access (e.g. transportation) to increase effective use of these preventive services. WEMC has also established relationships with community survivor groups to refer patients for emotional and psychological support. These programs have grown into well-rounded and high quality breast cancer prevention programs that serve many different aspects of a breast cancer patient’s needs.


Breast Cancer Prevention Program’s Growth and Focus on Quality Improvement

Outreach Focusing on Program Enrollment and Retention

West Medical Center, Inc. Breast Cancer Awareness Promotional MaterialsWEMC’s breast cancer prevention programs utilize a variety of innovative outreach strategies and community partnerships for recruiting and retaining patients such as sponsoring an annual breast cancer awareness luncheon for both WEMC program survivors and the community. During this event, WEMC program survivors are encouraged to talk about their experiences and to discuss the importance of early detection, describe the care process, and explain the differences in available support services.The luncheon has been valuable in helping patients see they are not alone in their fight to survive breast cancer.

For the past five years, WEMC has held “Roll Out the Pink Carpet” an annual event, in which WEMC partners with local businesses to provide spa services (e.g. manicures, pedicures, and facials) coupled with breast cancer education seminars. This event provides an opportunity for community members to speak with WEMC physicians, health educators and patient navigators and enroll in one of WEMC’s screening programs.

 

WEMC also partners with a variety of schools, beauty salons, and churches to disseminate information about the Centers’s programs to the community.  Most recently, WEMC sponsored tickets for women to see the movie “The Help”.  Targeting under-insured and uninsured women, WEMC was successful in signing up 39 women to receive their breast screenings and mammogram in one month.  WEMC programs also use home visits to minimize the number of patients lost to follow-up. Using such innovative approaches has allowed WEMC to achieve one of the highest enrollment and retention rates in the State of Georgia.

West Medical Center, Inc. Breast Cancer Programs Enrollment by year

The Role of the Patient Navigator and the WEMC Care Team

Once someone enrolls in one of WEMC’s programs, two Patient Navigators are then assigned to coordinate care and track a patient’s progress. The Patient Navigators are an important and successful QI piece in maintaining the programs’ focus on quality, determining changes in the system, and helping patients with their care.  They expertly navigate the vast complexity of breast cancer care and services while working with patients that may have limited education as well as lack financial means or insurance. Patient Navigators provide patients with a reliable and comforting safety net that help patients adhere to their care during a difficult time.  

In addition, the WEMC medical team makes sure patients stay engaged. For example, the OB/GYN staff works closely with WEMC breast cancer programs coordinators to provide outreach and assist patients with navigating through the process.  The staff stress the importance of follow up mammograms with each patient, providing appropriate health education,and alerts for “red flags” that may indicate a patient needs additional care, such as behavioral health management.

Expanding Age Demographics of Patients

For the past four years, WEMC has been the recipient of a Susan G. Koman, Greater Atlanta Affiliate Breast Cancer Screening and Diagnosis Grant. This funding allows WEMC to target women between 40-49 years old who are at a higher risk of developing breast cancer. This project’s expansion not only aims to save lives through earlier screening, but also educate women at a younger age of the importance of screening and early detection.
Internal and UDS Quality Measures For Breast Cancer

Since the inception of WEMC’s programs, they have used various quality measures to track the following:

  • Number of women enrolled in the program,
  • Number women receiving  mammograms;
  • Number of women in treatment.

The Patient Navigators track and report these quality measures on a monthly basis. These monthly reports are used for QI, such as support for WEMC’s internal audit efforts targeted at ensuring that patients are not being lost in follow-up. In addition, HRSA requires FQHC’s to submit breast cancer screening data through the UDS system for women 40 – 69 years of age.

Conclusion

WEMC’s unique programs combine the use of Patient Navigators with innovative outreach and retention activities to develop successful, innovative and continuously growing breast cancer prevention programs focused on Atlanta’s safety net population. Duane Kavka, The Executive Director of Georgia’s PCA remarks: “WEMC’s breast cancer and cervical screening program is an example of their strong leadership in Atlanta’s health care community. The growth and success of this particular program reflects their emphasis on meeting the community’s public health needs by focusing on quality improvement and trying innovative ideas for reaching out to Atlanta’s underserved patients.” The outreach activities, coupled with educational presentations, enable attendees to learn about the services offered by WEMC. Patient Navigators, responsible for coordinating patient care and tracking progress, have become an important component in maintaining the program’s focus on quality, determining changes in the system, and helping patients with their care.