Table 1 PDSA Cycle aims and high-level plans as submitted by health clinics

 Health Center 1

Create standardized process for CRC screening.

Test staffing models for mailing FIT kits. By June 1, 2015, have a standard workflow to increase percentage of patients screened for CRC.

 Health Center 2

Develop standard work for printing letters and mailing kits that can be sustained by support staff within teams. (~100 mailings per month).

Test scenarios for using alternative staffing models (like the front desk staff) and temporary staff to prepare and mail FIT kits.

 Health Center 3

Compare return rates from kits distributed in-clinic vs. kits mailed, and shorten the look-back period for mailed kits from 1 year to 3 months.

Pilot-test pre-visit planning to improve capture of CRC screening data in the medical record.

 Health Center 4

Improve the rate of FIT kit returns.

Test the mailing of the introductory letter with and without FIT and assess results for patients enrolled or not enrolled in the patient portal.

 Health Center 5

Determine whether a second reminder via phone call will increase the rate of FIT kit returns.

Test phone reminders.

 Health Center 6

Improve the rate of FIT kit returns.

Test the use of metered return mailing versus drop off at the clinic.

 Health Center 7

Improve the rate of FIT kit returns.

Test the mailing of FIT 1–2 weeks prior to scheduled clinic visit.

 Health Center 8

Resolve the issue that many completed FIT kits cannot be processed because the patient omitted the date(s) of collection on the kit label.

Improve materials to prompt patients to write the date of collection on the kit label.