Date of Award

January 2024

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Yale University School of Nursing

First Advisor

Mary Ann Camilleri

Abstract

Purpose: This DNP project piloted a virtual care navigation program for primary care patients inan urban population, aimed at improving compliance with colorectal screening and reducing disparities in access to care. Background: Despite the high prevalence and mortality, colorectal cancer screening remains low in the United States. This is especially true for patients who are uninsured, who are younger and for racial minorities. Colorectal Cancer can be largely prevented when appropriate screening is done. Digital navigation tools have demonstrated effectiveness in helping patients complete preventative health measures like cancer screening. Methods: This quality improvement project implemented a virtual navigation program for colorectal cancer screening within an urban primary care setting. Participants were identified based on institutional colorectal screening guidelines. The technology department supported the development of the virtual program using the enterprise patient engagement portal. Descriptive and bivariate statistics were used to evaluate outcomes of the 11-week pilot period. Recommendations were made to the organization for scaling and sustaining the program. Results: A total of 948 patients had an annual primary care visit at the pilot locations during the 11-week pilot period. Out of all patients, 78 met the inclusion criteria and were enrolled in the virtual navigation program. An overall increase of 5.94% was observed in the colorectal screening rate compared to the same period one year prior. The baseline and pilot period screening rates were compared using Pearson Chi-squared and a statistically significant difference was measured (p = 0.016). No differences in screening rates by race were observed. Conclusion: The virtual navigation program was successful at improving colorectal screening rates within an urban primary care population. Due to limitations in participant size, no differences in screening rates by race were observed.

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This is an Open Access Thesis.

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