Operationalizing a Rideshare Intervention for Colonoscopy Completion: Barriers, Facilitators, and Process Recommendations

Frontiers in Health Services

Health Services

Bryan J. Weiner¹  Peggy Hannon¹  Lisa Chew²  John M. Inadomi³  Lisa Strate⁴  Bryan Balmadrid⁴  Ari Bell-Brown⁵  Scott D. Ramsey⁶  Rachel B. Issaka⁷  Cara C. Lewis⁸ 

[1] Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, United States;Department of Internal Medicine, University of Washington School of Medicine, Seattle, WA, United States;Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States;Division of Gastroenterology, University of Washington School of Medicine, Seattle, WA, United States;Fred Hutchinson Cancer Research Center, Hutchinson Institute for Cancer Outcomes Research, Seattle, WA, United States;Fred Hutchinson Cancer Research Center, Hutchinson Institute for Cancer Outcomes Research, Seattle, WA, United States;Department of Internal Medicine, University of Washington School of Medicine, Seattle, WA, United States;Fred Hutchinson Cancer Research Center, Hutchinson Institute for Cancer Outcomes Research, Seattle, WA, United States;Division of Gastroenterology, University of Washington School of Medicine, Seattle, WA, United States;Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States;Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States;

关键词: colorectal cancer;    colonoscopy;    non-emergency medical transportation;    screening;    rideshare;   

DOI  :  10.3389/frhs.2021.799816

 received in 2021-10-22, accepted in 2021-12-14,  发布年份 2022

来源: Frontiers

【 摘 要 】

IntroductionTransportation is a common barrier to colonoscopy completion for colorectal cancer (CRC) screening. The study aims to identify the barriers, facilitators, and process recommendations to implement a rideshare non-emergency medical transportation (NEMT) intervention following colonoscopy completion within a safety-net healthcare setting.MethodsWe used informal stakeholder engagement, story boards—a novel user-centered design technique, listening sessions and the nominal group technique to identify the barriers, facilitators, and process to implementing a rideshare NEMT program following colonoscopy completion in a large safety-net healthcare system.ResultsBarriers to implementing a rideshare NEMT intervention for colonoscopy completion included: inability to expand an existing NEMT program beyond Medicaid patients and lack of patient chaperones with rideshare NEMT programs. Facilitators included: commercially available rideshare NEMT platforms that were lower cost and had shorter wait times than the alternative of taxis. Operationalizing and implementing a rideshare NEMT intervention in our healthcare system required the following steps: 1) identifying key stakeholders, 2) engaging stakeholder groups in discussion to identify barriers and solutions, 3) obtaining institutional sign-off, 4) developing a process for reviewing and selecting a rideshare NEMT program, 5) executing contracts, 6) developing a standard operating procedure and 7) training clinic staff to use the rideshare platform.DiscussionRideshare NEMT after procedural sedation is administered may improve colonoscopy completion rates and provide one solution to inadequate CRC screening. If successful, our rideshare model could be broadly applicable to other safety-net health systems, populations with high social needs, and settings where procedural sedation is administered.

【 授权许可】

Unknown   
Copyright © 2022 Bell-Brown, Chew, Weiner, Strate, Balmadrid, Lewis, Hannon, Inadomi, Ramsey and Issaka.