High performance in screening for colorectal cancer: a Practice Partner Research Network (PPRNet) case study.

INTRODUCTION Colorectal cancer (CRC) screening is recommended for average-risk adults age 50 and older, yet half of eligible US adults are not current. This case study of highest performing practices within the Colorectal Screening in Primary Care study (C-TRIP) explains practice strategies used and provides a model for improving CRC screening in primary care. METHODS A case study design was used to analyze practice performance data and qualitative data obtained from site visits, network meetings, and correspondence. The Practice Partner Research Network (PPRNet) Translating Research into Practice (TRIP) Quality Improvement (QI) model provided an analytic framework to evaluate the 5 highest-performing practices in the C-TRIP intervention. Practice strategies were grouped within the concepts: prioritize performance (PP), redesign delivery system (RDS), electronic medical record tools (EMR), and activate the patient (AP). RESULTS Thirteen specific practice strategies were exemplified within these four concepts (PP, RDS, EMR, AP). Most or all of these strategies were used by practices that achieved the highest proportion (up to 78%) of adults screened for CRC. CONCLUSIONS Primary care practices achieving a high proportion of CRC screening use systematic processes in the organization of their care. This case study provides a framework to organize systems that increase early detection and prevention of colorectal cancer.