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Breast in the West

Westmead Breast Cancer Institute
Project Added:
10 April 2015
Last updated:
23 April 2015

Breast in the West

Summary

This project aims to increase awareness of the benefits of mammograms among General Practitioners (GPs) and women in Western Sydney, through education and training initiatives. 

Poster from the Centre for Healthcare Redesign graduation  Poster from the Centre for Healthcare Redesign graduation, April 2015. 

Aim

To increase the early detection of breast cancer through increased uptake of mammograms among women aged 50-74 in Western Sydney.

Benefits 

  • Increased GP referrals to BreastScreen Sydney West (BSSW)
  • Increased number of women screened by BSSW, leading to early detection of breast cancers.
  • Improved health literacy and reduced fear of mammography procedures, through clear health promotion messages and audience-specific education strategies.
  • Improved referral rates and participation in cancer screening programs across Western Sydney.
  • Improved patient outcomes through early screening and detection.

Project status

Project start date: 23 July 2014.

Project status: Implementation - the initiative is ready for implementation, is currently being implemented, piloted or tested.

Background 

Although one in eight Australian women will be diagnosed with breast cancer by the age of 85, less than half of all women aged 50-74 years within Western Sydney Local Health District (WSLHD) are currently having regular mammograms. The Western Sydney area has one of the lowest BreastScreen participation rates for women aged 50-74 in NSW.

Data indicates that GPs, as primary providers of health-related information, are infrequently referring women for mammograms. When the project was first started around 7-10% of women booking a mammogram indicated that they were prompted by their GP.

Implementation 

  • Developed an education package for GPs.
  • Engaging with ‘champion’ GPs to inform best practice among their peers.
  • Developed education sessions for women in workplace and community groups.
  • Displayed posters in GP surgeries, on community noticeboards and in BSSW clinics.
  • Developed an information pack that reinforces regular screening for well women.
  • Developed training for BreastScreen booking staff.
  • Conducted a trial where multiple sources of referral were manually recorded.

Implementation sites

  • Lead organisation: Westmead Breast Cancer Institute
  • GP surgeries in Western Sydney.
  • BreastScreen Clinics in Auburn Hospital, Myer Blacktown, Myer Castle Hill, Mt Druitt Hospital and Myer Parramatta.
  • Workplaces and community settings in Western Sydney.
  • BreastScreen bookings office, Westmead.

Partnerships

  • Western Sydney Local Health District (WSLHD)
  • Western Sydney Medicare Local
  • Wentwest
  • Cancer Institute of NSW

Evaluation 

  • Pre- and post-knowledge questionnaires will be used to assess change in GP knowledge before and after GP education sessions.
  • BSSW reports will be used to assess changes to the number of GPs listed as a source of referral for mammogram bookings.
  • BSSW reports will also be used to assess changes in data entry by bookings staff as a result of staff training.

Lessons Learnt 

  • Scheduling time with GPs is challenging.
  • Strategies to engage GPs and maintain ongoing communication with GPs requires careful allocation of resources.
  • There is a need for continuous collaboration between colleagues, for example motivating bookings staff to accurately record source of referral.
  • It was essential to address the absence of two-way communication and collaboration between BreastScreen Screening and Assessment Services and the Cancer Institute of NSW who have a common goal to improve the uptake of mammograms.
  • Effective communication is essential to avoid:
    • impediment of local initiatives which are prioritised second to statewide activities
    • less than ideal use of resources to identify ways of improving screening participation
    • disregard of available critical information e.g. feedback from end users about current systems/applications and formats for reports to measure and manage the service.

Further Reading

  1. Australian Institute of Health and Welfare and Australasian Association of Cancer Registries. Breast cancer in Australia: an overview. Cancer series no. 74. Cat. No. CAN 70. Canberra: AIHW; 2012.
  2. Australian Institute of Health and Welfare. Australian Cancer Incidence and Mortality (ACIM) Books: Breast cancer. Canberra: AIHW; 2015. 
  3. Pace LE, Keating NL. A systematic assessment of benefits and risks to guide breast cancer screening decisions. Journal of the American Medical Association 2014; 311(13): 1327-1335.
  4. Australian Institute of Health and Welfare 2013. BreastScreen Australia monitoring report 2010-2011. Cancer series no. 77. Cat. No. CAN 74. Canberra: AIHW.
  5. BreastScreen Information System. Source of referral for appointments report 2014; Accessed 10 April 2014.
  6. Royak-Schaler R, Klabunde C, Green W, Lannin D, DeVillis B, Wilson K et al. Communicating breast cancer risk: patient perceptions of provider discussions. Medscape Women’s Health 2002; 7:2.
  7. Achat H, Close G, Taylor R. Who has regular mammograms? Effects of knowledge, beliefs, socio economic status, and health-related factors. Preventive Medicine 2005; 41: 312-320.
  8. Ahmed NU, Fort JG, Elzey JD, Bailey S. Empowering Factors in Repeat Mammography: Insights from the Stories of Underserved Women. Journal of Ambulatory Care Management 2004; 27(4): 348-355.

Contact

Margie Drake
Marketing & Recruitment Manager
BreastScreen Sydney West
Phone: 02 9845 9482
Email: margaret.drake@bci.org.au

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