MPRO's Role in Michigan's BCCCP

Since 1999, MPRO has collaborated with the Michigan Department of Community Health (MDCH) and the Michigan Public Health Institute (MPHI) to improve cancer prevention for underserved women enrolled in the Michigan Breast and Cervical Cancer Control Program (BCCCP), a screening program funded by the Centers for Disease Control and Prevention (CDC). MPRO has conducted annual program evaluations, within the context of a collaborative quality improvement project, to assist the statewide program in meeting quality improvement goals while measuring current adherence to performance standards.

Annually, MPRO collects data from randomly selected clinical records to assess adherence to quality indicators drawn from CDC screening standards and MDCH accreditation standards. MPRO analyzes and reports indicator adherence rates to 20 local coordinating agencies (LCAs) located throughout Michigan. We produce annual reports to each LCA. MPRO has provided multiple quality improvement interventions spanning eight years including statewide continuous quality improvement (CQI) training, CQI tools, data trends analysis and reports, and consultation to local coordinators to assist with data interpretation and development of performance improvement plans. MPRO provides CQI consultation to MDCH and MPHI that results in a client focused CQI plan empowering local coordinators to improve client outcomes.

In 2003, MPRO implemented a pilot study as the initial step toward independent data abstraction at the LCA level, to ultimately achieve concurrent evaluation of clinical performance. After making hardware and software available to five LCAs, MPRO trained LCA program staff to abstract clinical data from sampled records. The BCCCP pilot study was expanded in 2004 to include all LCAs statewide. Following training provided by MPRO, local abstractors collected clinical data and sent it to MPRO for analysis. MPRO reports data findings to each LCA and provides guidelines and tools to assist collaborators to interpret the results and to identify performance strengths and opportunities for improvement of their BCCCP program. MPRO project staff consults with LCA coordinators by telephone to help prioritize improvement opportunities and develop improvement strategies.

Over the years, study results were consistently positive. Improved cancer screening outcomes for women in Michigan were evidenced by the increasing adherence rates to performance indicators documented throughout this collaborative project. Additionally, LCA coordinators in 2005 and 2006 have assumed increasing responsibility for evaluating and improving program processes and working collaboratively with centralized staff to improve statewide processes.

MPRO continues to assist MDCH and MPHI to expand and support the BCCCP quality infrastructure, to collect and analyze performance data and to provide consultation to continuously improve clinical outcomes.