Systems change: Clinic assessment checklist

Conducting a clinic assessment

A self-assessment survey such as this one can be used to identify necessary resources that are already in place at the clinic site and where there might be gaps.
Medical records
  • Do patient charts indicate current screening status for (prevention topic)?
  • Do patient charts indicate date and method (if applicable) of last screening?
  • Do patient charts indicate increased risk status due to family history?
  • Does your medical record systems what the capacity to provide a list of patients who aren’t up to date with this screening/test?
Staff roles
  • Is there a designated staff person who provides information to patients about this screening?
  • Is there a designated staff person who recommends this screening to appropriate patients?
  • Is there a designated staff person who follows up with patients who agree to be tested?
  • Are your providers aware of current guidelines for this screening?
  • Are there current guidelines for this screening available for clinician reference?
  • Does your clinic have materials available to patients on this topic?
  • Does your clinic have a process for following up with patients who fail to keep their screening appointment?
  • Does your clinic have a process for receiving and documenting test results for patients who are referred to a specialist for screening?
  • Has your clinic’s financial administrator identified health plan coverage, diagnosis and billing codes for this screening?
  • How are patients referred to programs such as Medicaid if they qualify?
Adapted from "Options for Increasing Colorectal Cancer Screening Rates in Community Health Centers,"University of North Carolina Lineberger Comprehensive Cancer Center.