KPNW's Safety Net for Preventive Services: The Challenge of Reaching the Unscreened

Nancy H. Stevens, PhD

Fall 1998 - Volume 2 Number 4

In 1991, a Middle Management Development Project (MMDP) proposed that Kaiser Permanente Northwest (KPNW) strengthen its prevention program by creating a Safety Net. The proposal called for the prevention Safety Net to ensure that members at greatest risk, eg, the unscreened, would receive services known to be effective in decreasing the risk of morbidity and mortality.

In 1994, a Prevention Steering Committee selected breast and cervical cancer screening as initial Safety Net interventions as these were known to be cost-effective and to have predictable screening intervals. A dual strategy was developed: unscreened members would receive an outreach letter; in addition, those who had clinical encounters would receive a verbal reminder from their clinician that they were overdue for screening.

Data suggest that the Safety Net has contributed to improved screening performance. Moreover, preliminary data from KPNW's Tumor Registry suggest that we are finding a greater incidence of invasive cervical cancers that may have gone undetected without the Safety Net initiative. KPNW believes the Safety Net has enhanced preventive services for the Region. The Safety Net should prove to be a potent strategy for other preventive and population-based screening services.



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