Enhancing equity and efficiency in cervical screening uptake: a multidisciplinary quality improvement initiative.

Abstract

Background: Cervical cancer screening is vital for early detection and prevention, yet uptake remains suboptimal in diverse communities.

Local problem: Cauldwell Medical Centre reported cervical screening uptake rates of 54% (ages 25-49) and 62% (ages 50-64) by June 2022, both significantly below the national target of 80%, with a concerning 8 percentage point disparity between age groups.

Methods: Using quality improvement (QI) methodologies, including Plan-Do-Study-Act cycles and statistical process control charts, the team tested eight cycles of change grouped into three high-impact actions designed to improve accessibility, trust and personalisation of cervical screening services. Tests of change included culturally sensitive outreach, extended clinic hours and a self-booking system to enhance accessibility and engagement.

Results: This QI initiative achieved a marked reduction in age-related inequalities in cervical screening uptake. By the end of the intervention period (March 2023), screening rates increased from 54% to 69% among women aged 25-49 and from 62% to 72% among women aged 50-64, narrowing the gap from 8 to 3 percentage points-a 60% reduction in disparity. By the final monitoring week, uptake further increased to 73% (ages 25-49) and 82% (ages 50-64), demonstrating how structured QI approaches can amplify the effectiveness of existing healthcare processes.

Conclusions: This project highlights that systematically applying QI methodologies can effectively address healthcare inequalities, providing a scalable model for improving cervical screening uptake among under-represented populations.