No abstract

No abstract

No abstract

A burgeoning number of toolkits dedicated to improving health care exist but development guidance is lacking. The authors convened a panel of health care stakeholders, including developers, purchasers, users, funders, and disseminators of toolkits. The panel was informed by a literature review that analyzed 44 publications and 27 toolkits. A modified Delphi process established recommendations and suggestions to guide toolkit development. The panel established 12 recommendations for content and 1 recommendation for toolkit development methods. The recommendations are accompanied by 11 suggestions for toolkit content, 9 suggestions for development methods, and 6 suggestions for toolkit evaluation methods. The authors established a set of key recommendations and suggestions addressing the content, development, and evaluation methods of quality improvement toolkits, together with a ready-to use checklist. The guidance aims to advance the value of toolkits as an emerging method to effectively disseminate interventions to improve the quality of care.

Background Colorectal cancer (CRC) is the second-leading cause of death in the USA. CRC screening remains underutilized, especially in underinsured populations. Screening has been heavily disrupted during the COVID-19 pandemic. Purpose The goal is to explore the impact of the pandemic on ethnic and gender disparities in CRC screening. Methods Patients were identified 1 year before and after COVID-19 precautions began, using March 1, 2020, as the inflection point. The primary inclusion criterion was an ordered colonoscopy. The outcome of interest was a colonoscopy performed. Differences by year and race were assessed using chi-square analysis. A cohort of 1549 patients (899 in pre-COVID; 650 in post-COVID) between age 45 and 75 for whom a colonoscopy was ordered was selected from EHR at a large institution. Results There was a 51% reduction in screening colonoscopies performed. White patients had a decrease of 49%, and African Americans had a 55% reduction. Stool testing increased from 47% prior to the pandemic to 94% during the pandemic representing a greater than 100% increase in stool testing uptake. ConclusionThe true impact of COVID-19 on colorectal cancer is yet to be uncovered as future mortality estimates from CRC are ongoing. Due to the widespread closure of endoscopy centers and delay in screening, we believe that the pandemic worsened the screening disparities most prevalent among minority populations. Our study points to the drastic reduction of screening for all races, especially for African Americans.