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Table 5 Informants’ quotes of needs and recommendations for the CRC Task Force

From: Implementation of a novel program to support colorectal cancer screening in a community health center consortium before and after the onset of COVID-19: a qualitative study of stakeholders’ perspectives

Themes

Quotes

Needs

 Additional staff

QI manager: “Honestly, the first thing that comes to mind is more staffing just internally, just because people are so short on time with all of the duties that they already have and honestly, just a little bit more planning on our end. I feel like, because there’s a lot of potential that we can do. We just haven’t implemented mail FIT for example, or any of those things.”

Screening champion: “Of course always having additional staff or correct amount of staffing just to make sure that patient care is being met.”

 Support for FIT kits/mailed FIT kits

Medical director: “Getting the supports to do mailings because you couldn’t have a better rationale to do that than COVID, that would be the major. And we’d have to find a way so that the clinic was significantly supported in a way where there were the financial resources to say, ‘Let’s do this as a pilot, and get the data and learn during COVID, how effective can this be?’”

QI director: “I think purchasing the colorectal cancer screening test kits, and providing them to us in addition to the funding would be ideal. This way, we’re using a FIT kit that they have vetted, or SF CAN has vetted and purchased and provided to us.”

Patients’ outreach and follow-up

 Educational materials

QI manager: “Maybe if there can be more educational resources, that would be helpful that we can disseminate and share with others in our clinic. And that would be for staff, like staff education as well as patients education I think.”

 Other materials—protocols

QI manager: “I think if we were to restart working with SF CAN, what will be helpful is just some basic outline of a protocol that’s worked with another clinic to get started. Like a guide plan to getting involved in the screening efforts again.”

 Trainings

Screening champion: “I think for right now that is maybe just another in-person or virtual teaching training session, like they did, it was probably over a year ago, to train any of our new staff that have come on since then.”

 Support/advocacy QI efforts

QI manager: “I would say, helping to advocate for the QI staff, that they need more time to get results, because one hour a week is not enough, but the only way to change that is for the senior level, and executives to agree to make some big changes. And I think having extra support to advocate for that because that’s the next step. Does that mean hiring another staff member? Does that mean giving one shift a week, so you have four hours a week or is it one day a week to your QI staff? And really cementing that culture in there. So I think that at some point, if you have kind of those voices from an outside person working together with the QI, to really move that transition, I think would be helpful.”

Recommendations

 Increase stipend

SFCCC leader: “I mean, they could give out more money to be devoted towards colorectal cancer screening.”

QI manager: “From an admin perspective, I think support has been great. The financial piece, I would say could be a little more.”

 Sharing lessons learned

Medical director: “To learn about best practices from other clinics and what other people are doing and how they’re addressing this with the homeless population and what kind of results people are getting and things like that.”

Screening champion: “I think whatever kind of advice, or tips, or any sort of resources that other community health centers or just other health centers have learned or have created with addressing CRC screening when a lot of patients are not coming into the clinic

 Additional resources

SFCCC leader: “You know, if SF CAN had infinite resources and could fund a staff person whose job it would be to coordinate cancer screening in the clinics, that would be great. Then there would be a dedicated resource in general, SF CAN doesn’t have that level of resource, but if they did, that would be great. If we had a staff person who was dedicated to cancer screening, then it would be a lot easier to accomplish that. The staff person could work directly with the clinics in terms of improving cancer screening measures.”

 Have a regular schedule for meetings

QI manager: “I would say maybe keeping somewhat of a regular schedule on check-ins. My understanding is that they were a little bit more sporadic, but if there was, for example, a calendar that said every first quarter of each month, Monday, we meet with SF CAN, then I think that’s something that’s on the calendar that is setting a meeting with an agenda I think would have been helpful.”