North Texas GME Research Forum 2023



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North Texas


Medical City Arlington


Family Medicine

Document Type


Publication Date



breast cancer, breast cancer screening, breast neoplasms, early detection of cancer


Diagnosis | Family Medicine | Neoplasms


Introduction: Over 264,000 cases of breast cancer are diagnosed annually within the United States, with 99% of them being in women. Regarding prevention of this terrible disease, early detection of such cancers through screening mammography has up to a 20% reduction in breast cancer mortality. Therefore, the USPSTF recommends screening of women who are 50-74 years of age via mammography at average risk of breast cancer every two years. The goal of this study was to measure, track, and increase compliance with these screening recommendations within the Medical City resident clinics.

Method: Family medicine residents working were presented with a standardized electronic medical record template to improve the rate of recorded breast cancer screenings within appropriately aged women. The template would be used for patients who are referred for the imaging study, and completed once the patient presented the results of the completed study. Residents were additionally tracked on how many patients they appropriately referred for screening. Education was given to all residents and nurses responsible for the referral process and on the importance of the correct implementation and recording of a successful mammogram referral. The developed protocol was used within the Family Medicine outpatient clinic sites at Grand Prairie, North Hills, and Denton to increase screening compliance.

Results: All three clinic sites measured in the study showed an overall compliance rate of 17.35%. Data was also grouped by resident year and individual. However, this data may not represent the true compliance rate, as reports were frequently not attached to the initial screening template order by nursing staff secondary to high clinic staff turnover rates.

Conclusion: Efforts to improve compliance with current USPSTF guidelines on breast cancer screening were not reflective of adherence to the standardized template, and will require additional study design improvement. Additional cycles of the study will feature nursing specific education didactic sessions regarding proper, and data from both pre- and post- education sessions will be compared to measure true resident screening compliance rates.

Original Publisher

HCA Healthcare Graduate Medical Education

Outpatient Breast Cancer Screening Documentation



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