Improving physician compliance with mammography screening by implementing a breast cancer screening guideline at a hospital in Bahrain

Abstract

Background: From a health and safety perspective, it is critical to use adequate, evidence-based breast screening guidelines. The aim of this quality improvement project was to improve physicians' compliance with breast cancer screening guidelines to enhance the mammography screening rate among eligible women; this was achieved through the implementation of multifaceted changes to the hospital's processes and the improvement of physicians' attitudes towards the guidelines.

Methods: The project used the Plan-Do-Study-Act method to implement the changes. This was a pre-post evaluation study. The data were collected from patients' charts. The primary outcome of interest was the rate of physician compliance with mammography screening guidelines before and after the implementation of the process changes. A literature review was conducted to determine which women should be identified as eligible for mammography screening.

Intervention: The interventions targeted physician knowledge and hospital processes. Improving doctors' expertise was achieved by implementing the US Preventive Service Task Force recommendation for mammography screening every 2 years for women aged 50-74 years. The process modifications included the establishment of a system that would be effective in identifying at-risk patients and reminding physicians at the point of care.

Results: Over the course of this study, 825 patients met the criteria for breast cancer screening. The rate of physician compliance with the breast cancer screening guideline increased from 2% to 69% after 23 weeks, and the control charts demonstrated a reliable process.

Conclusion: This project examined the relationship between different interventions (identification of the eligible patient, reminder alerts and physician knowledge) and physician compliance with mammography screening guidelines. The results suggest a positive link between the study variables and physicians' compliance with mammography screening guidelines.

Keywords: efficiency; evidence-based medicine; implementation science; organisational; patient safety; quality improvement methodologies.