Department of Family and Community Medicine University of California, San Francisco CA 94143-0900

Staff Training

Setting up a FluFIT Program requires training. The training that you provide will depend on how  you organize your program and the type of staff that are involved.  For example, if your clinic site is already experienced in providing FIT to patients without a doctor’s order, your team may not need very much training at all.  However, if your team has never provided FIT in the past, more training will be needed.

The 5 key elements to your training:
1. Information about the importance of both flu shots and colorectal cancer screening

Everyone on your team should know a few facts about flu shots and colorectal cancer screening:

  • Facts about Flu and Flu Shots:

• Flu is often mild, but can be a very serious illness.
• Every year, over 100,000 people are hospitalized with the flu, and many die.
• Flu shots are one of the best tools we have to prevent people from getting flu.
• Flu shots are safe when provided as directed.
• Flu shots do not cause the flu.
• Flu shots are recommended for everyone over the age of 6 months.

More information about flu and flu shots can be found on the CDC’s seasonal flu website:

  • Facts about Colorectal Cancer and Colorectal Cancer Screening:

• Colorectal cancer is the second leading cause of cancer in the United States.
• More than 50,000 Americans die of colorectal cancer each year.
• Colorectal cancer is often preventable with screening.
• Early detection and treatment saves lives.
• There are more than 1 million colorectal cancer survivors in the United States.
• Colorectal cancer screening is recommended between the ages of 50 and 75.

More information about colorectal cancer and colorectal cancer screening can be found on the USPSTF website:

2. Organize your workflow efficiently

In most clinical settings, it most efficient and effective to give the patient their FIT kit while waiting to get the flu shot, rather than after the flu shot has already been given.

It is also important to consider your space with the comfort of both patients and clinic staff in mind.

If you have a busy high volume setting, you will want to have someone dedicated to managing the flu shot line to keep things running smoothly.  You may also want to set up a separate station for FIT several feet in front of the station where flu shots are being offered. 

If you are in an outpatient clinic that is providing the FluFIT Program during primary care visits, or in a lower volume setting with limited space, you will likely want to provide FIT and flu shots together at the same clinic station. Make sure to select all of your patient education materials in advance and have your work stations well stocked with FIT kits and flu shots so that your team is well prepared for success.  You may want to arrange to have a computer in the room to allow the patient to watch one of our brief videos about how to complete screening while the flu shot is being prepared for administration.

3. Arrange to provide flu shots and FIT without waiting for a doctor’s order

The CDC has developed detailed free training programs for health professionals and clinic staff who provide flu shots. These can be accessed at:

Patients are eligible for colorectal cancer screening with FIT if they are between the ages of 50 and 75 and also have had:

  • No FIT in the last year
  • No colonoscopy in the last 10 years

Patients who have had other tests such as sigmoidoscopy may also benefit from FIT. However, patients who have had previous abnormal FIT or other recently abnormal colorectal cancer screening tests should be referred for colonoscopy to check for polyps or cancer before having FIT repeated.

Eligibility for FIT may be determined by reviewing clinic charts or your electronic health record either before or during the clinic visits. When clinic charts or electronic health records are not available, the clinic staff can ask the patient about prior FIT and colonoscopy procedures. As long as the patient is reasonably certain that he or she has not completed a recent FIT kit and that they have not had a colonoscopy for the last several years, it is reasonable to offer a FIT kit with their flu shot.

4. Talk to patients about FIT and how to complete the test

Colorectal cancer screening is a serious topic, but patients are usually receptive to hearing about it, especially when the conversation is kept simple and light. What you say to patients will depend on how your FluFIT Program is set up and what type of kit you provide to patients. Effective talking points may include phrases like this:

  • We have something extra to offer you today!
  • It looks like you are due for a home colon test.
  • Colon cancer screening can save lives.
  • Just like a flu shot, all our doctors and nurses recommend home colon tests.
  • It’s very easy — you can do it in the privacy of your home and mail it in.
  • We’ll make sure the results get to your doctor.

Patients who accept the kit should be given additional written material and instructions. If the patient is unfamiliar with FIT, it is can be useful to take a moment to show the patient the kit and offer simple instructions with a visual aid or a brief instructional video. We have provided sample scripts and patient education materials on our PROGRAM MATERIALS page.

5. Record keeping and patient follow-up

Keep a record of which patients were given FIT. This information can be kept in a log sheet where flu shots are also recorded. This list can be useful to determine test return rates and to provide reminders to patients who have not yet returned kits that have been dispensed. The log sheet can also be used to create a list of patients who need follow-up for abnormal tests. Examples of a log sheet and abnormal test result tracking form is listed in PROGRAM MATERIALS Page