1 Colon Screening Program Standards: Patient Coordinator Model version: 22march2016. 2 Colon Screening Program This report was produced by the Colon Screening Program at the BC Cancer Agency Preferred citation: BC Cancer Agency: Colon Screening Program Patient Coordinator Standards. BC Cancer Agency, 2013 For more information please contact: Colon Screening Program 801 686 West Broadway Vancouver, BC V5Z 1G5 Web: Email: Phone: 1 877 70 Colon (26566) Fax: 1 604 877 6103 Colon Screening Program Patient Coordinator Standards 22 Mar 2016 (R) 3 Acknowledgements The BC Cancer Agency (BCCA) would like to thank everyone who assisted in the development and refinement of the Colon Screening Program 's Standards: Patient Coordinator Model. Co authors Dr. Jennifer J. Telford, BC Cancer Agency Dr. Denis Petrunia, Vancouver Island Health Authority Contributors Sheila Campbell, Vancouver Island Health Authority Dr.
2 Justin Cheung, Fraser Health Authority Dr. Martin Fishman, Vancouver Coastal Health Authority Laura Gentile, BC Cancer Agency Judith Hockney, Fraser Health Authority Laura Johnston, Northern Health Authority Dr. Brian Tighe, Interior Health Authority It has been the innovative and transforming work of the Colon Screening Program 's Colonoscopy and Patient Coordination Working Group that inspired and informed the development of these guidelines. We would also like to thank the management of the BCCA Screening programs , the BCCA executive sponsors of the Colon Screening Program , the Provincial Health Services Authority (PHSA), the Ministry of Health, the BC Society of Gastroenterology, the Section of General Surgery, the Society of General Practitioners of BC, the BCCA Gastrointestinal (GI) Tumour Group, and the Colon Screening Program Advisory Committee.
3 About the BC Cancer Agency The BC Cancer Agency, an agency of the Provincial Health Services Authority, provides a comprehensive Cancer control Program for the people of BC in partnership with regional health authorities. This includes prevention, Screening and early detection programs , research and education, and care and treatment. The BC Cancer Agency's mandate is a three fold mission: To reduce the incidence of Cancer To reduce the mortality rate of people with Cancer To improve the quality of life of people living with Cancer This mission drives everything we do, including providing Screening , diagnosis and care, setting treatment standards, and conducting research into causes of, and cures for, Cancer . Colon Screening Program Patient Coordinator Standards 22 Mar 2016 (R) 4 Table of Contents Introduction Colon Screening Program .
4 Purpose of the Standards . Sources of Information .. General Principles . Qualifications .. Pre Colonoscopy Assessment Direct Observation of Procedural Skills Assessment and Patient Education Bowel Preparation . Alerts for Colonoscopy Pre colonoscopy Assessment . Antithrombotic Therapy . Cardiac Defibrillator .. Diabetes . Iron tablets .. Glaucoma Renal insufficiency/dialysis .. Congestive Heart Failure (CHF) . Informed Consent .. Post Colonoscopy Assessment Telephone Follow up at 14 Days . Unplanned Events .. Re Screening and Surveillance Guidelines . Quality Assurance Data Collection .. Patient Coordinator Performance Indicators .. References Appendix A Patient Coordinator Assessment Form .. B Colonoscopy Brochure .. C Sample Not Proceeding to Colonoscopy Letter . D Unplanned Events Form.
5 E Follow Up Form F Colonoscopy Reporting Form . Colon Screening Program Patient Coordinator Standards 22 Mar 2016 (R) 5 1. Introduction Colon Screening Program colorectal Cancer (CRC) is the third most common Cancer and the second leading cause of Cancer death in Canada and in other developed countries1. The Colon Screening Program seeks to reduce the incidence and mortality of colorectal Cancer by providing timely and equitable access to high quality Screening and diagnostic services to eligible men and women ages 50 to 74in BC. Purpose of the Standards Patient Coordinators are Regional Health Authority nurses who play an essential role in the Colon Screening Program . These Standards are designed to maximize participant safety and Program efficiency and efficacy by ensuring the Patient Coordinator role is clearly understood and carried out in an effective, consistent manner across the province.
6 Sources of Information The Standards: Patient Coordinator Model are based on the experiences of the BC Cancer Agency Colon Check pilot Program , the Vancouver Island Health Authority Pilot Program and the NHS Bowel Cancer Screening Programme (UK). General Principles Early detection reduces Colon Cancer incidence and mortality. The application of evidence informs policy, system design and ongoing management and clinical decision making. The planning and delivery model is based on population distribution data and is responsive to the needs of the entire eligible population in British Columbia. Services are delivered by suitably trained, competent and qualified clinical and non clinical staff. Services delivered are safe, effective, of high quality and quality assured. 2. Qualifications Clinical aspects of the patient coordinator model ( clinical assessment and patient teaching) must be completed by a registered nurse, preferably with experience in patient education.
7 Supportive components of the model ( booking patients for assessment, faxing information, completing the procedure booking process can be done by clerical support staff as deemed appropriate by the health authority). When required, specialist precolonoscopy assessment must be completed by a specialist who meets the Colonoscopist qualifications in the Standards: Colonoscopy. Colon Screening Program Patient Coordinator Standards 22 Mar 2016 (R) 6 3. Pre colonoscopy Assessment Program Criteria The eligibility criteria for the Colon Screening Program are: ages 50 74 asymptomatic Patients are referred to the Program by health care providers. Health care providers are provided with information on the eligibility criteria for the Program and it is expected that providers consider and adhere to the criteria.
8 However, some health care providers will, at times, refer patients through the Program who are outside of the age range or who have symptoms. If received by the BC Cancer Agency, the agency will refer patients with abnormal FIT results or family history criteria on to the patient's health authority for assessment. The BC Cancer Agency is supportive of collecting all data and outcomes for these patients, by completion of the usual model, for patients who are outside the Program age range or who may present to the patient coordinator with symptoms. The Program also recognizes that health authorities or endoscopy units may want to manage these patients through a different route ( health authority routes referral to specialist for full consult and colonoscopy booking, if appropriate, through the specialist's office).
9 As such, page 3 of the Patient Coordinator Assessment Form provides options for either retaining the patient in the Program for assessment, colonoscopy and follow up or for indicating back to the BC Cancer Agency that the patient will not be followed by the Program . For patients who will not be followed by the Program , please indicate option Not proceeding: assessment/colonoscopy to occur outside of the Program on page 3 of the Patient Coordinator Assessment Form. The identification of patients who do not meet Screening Program criteria may occur at the time of referral from the BC Cancer Agency to the health authority or through the patient assessment process. Recall processes for patients who are registered and followed by the Program for their Screening episode are outlined in the Standards: Colonoscopy.
10 Colon Screening Program Patient Coordinator Standards 22 Mar 2016 (R) 7 Assessment and Patient Education Contact referred patients and establish time to complete assessment. Each Regional Health Authority will determine whether the assessment takes place by telephone, in person or through group education sessions. Self reported height and weight is acceptable for phone assessments. Complete the Patient Coordinator Assessment Form (see Appendix A). o Identify any high risk factors that require colonoscopist assessment prior to colonoscopy and refer patient as indicated. See Section 3 and Patient Assessment Process document. o Send page 3 of the Patient Coordinator Assessment Form to the BC Cancer Agency. Provide education to the patient regarding: o Implications of an abnormal FIT and the reasons for colonoscopy follow up.