Reducing Rejected Fecal Immunochemical Tests Received in the Laboratory for Colorectal Cancer Screening.

Background: Colorectal cancer (CRC) screening decreases CRC incidence; however, many patients are not successfully screened.
Purpose: To improve screening rates at our institution by decreasing the rate of rejected fecal immunochemical tests (FITs), a means of CRC screening, from 28.6% to <10% by December 2017.
Methods: Specimens were rejected for the following reasons: expired specimen, lack of recorded collection date/time, lack of physician orders, incomplete patient information, and illegible handwriting. Multidisciplinary teams devised the following interventions: FIT envelope reminder stickers, automated FIT patient reminder phone calls, a laboratory standard operating procedure, an accessioning process at satellite laboratories, revisions to a clinical reminder when offering FIT, and provision of FIT-compatible printers to clinics.
Results: Total specimens received each month ranged from 647 to 970. Fecal immunochemical test rejection rates fell from 28.6% in June 2017 to 6.9% in December 2017 with a statistically significant decrease (p-value = .015) between the intervention period (May 2017-October 2017) and the postintervention period (November 2017-May 2018).
Conclusions: Targeted interventions with stakeholder involvement are essential in reducing the rejection rate.
Implications: The decreased rejection rate saves resources by decreasing the need to rescreen patients whose specimens were rejected, and may improve CRC screening rates.