The abstract is read at the publisher; the summary is JClub's.
Implementing a clinic-level Best Practice Bundle across 12 adult primary care clinics in the San Francisco Health Network increased colonoscopy completion within 180 days after abnormal FIT from 44.1% to 60.1%.
- Why it matters: Many safety-net patients with abnormal fecal immunochemical tests miss timely diagnostic colonoscopy, and barriers span clinic workflows and patient follow-up steps.
- What they did: The IMPACTT study used a stepped-wedge rollout of a Best Practice Bundle (tracking, standardized EHR documentation, education/communication, audit and feedback) and, in parallel, randomized eligible patients to patient instruction and navigation versus usual care.
- The result: In preliminary unadjusted comparisons, timely gastroenterology referral within 42 days rose from 69.8% to 84.2% and median FIT-to-colonoscopy time fell from 131 to 86 days, while the randomized PIN intervention showed no difference in 180-day completion (58.4% vs 57.7%).
The findingWhy it mattersWhat they didThe result
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