Nimble Approach: fast, adapting, calculating and ethically mindful approach to managing colorectal cancer screening programmes during a pandemic

Objective To describe a conceptual framework that provides understanding of the challenges encountered and the adaptive approaches taken by organised colorectal cancer (CRC) screening programmes during the initial phase of the COVID-19 pandemic.Design This was a qualitative case study of internation...

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Main Authors: Nancy N Baxter, Arlinda Ruco, Jill Tinmouth, Catherine Dubé, Anne Sorvari, Linda Rabeneck, Natalie A Baker, Marcia Facey, Amina Benmessaoud
Format: Article
Language:English
Published: BMJ Publishing Group 2022-11-01
Series:BMJ Open Gastroenterology
Online Access:https://bmjopengastro.bmj.com/content/9/1/e000826.full
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author Nancy N Baxter
Arlinda Ruco
Jill Tinmouth
Catherine Dubé
Anne Sorvari
Linda Rabeneck
Natalie A Baker
Marcia Facey
Amina Benmessaoud
author_facet Nancy N Baxter
Arlinda Ruco
Jill Tinmouth
Catherine Dubé
Anne Sorvari
Linda Rabeneck
Natalie A Baker
Marcia Facey
Amina Benmessaoud
author_sort Nancy N Baxter
collection DOAJ
description Objective To describe a conceptual framework that provides understanding of the challenges encountered and the adaptive approaches taken by organised colorectal cancer (CRC) screening programmes during the initial phase of the COVID-19 pandemic.Design This was a qualitative case study of international CRC screening programmes. Semi-structured interviews were conducted with programme managers/leaders and programme experts, researchers and clinical leaders of large, population-based screening programmes. Data analysis, using elements of grounded theory, as well as cross-cases analysis was conducted by two experienced qualitative researchers.Results 19 participants were interviewed from seven programmes in North America, Europe and Australasia. A conceptual framework (‘Nimble Approach’) was the key outcome of the analysis. Four concepts constitute this approach to managing CRC screening programmes during COVID-19: Fast (meeting the need to make decisions and communicate quickly), Adapting (flexibly and creatively managing testing/colonoscopy capacity, access and backlogs), Calculating (modelling and actively monitoring programmes to inform decision-making and support programme quality) and Ethically Mindful (considering ethical conundrums emerging from programme responses). Highly integrated programmes, those with highly integrated communication networks, and that managed greater portions of the screening process seemed best positioned to respond to the crisis.Conclusions The Nimble Approach has potentially broad applications; it can be deployed to effectively respond to programme-specific challenges or manage CRC programmes during future pandemics, other health crises or emergencies.
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spelling doaj-art-b90a5c3bf52f431a8eb91baff4e7f64d2025-08-20T03:45:14ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742022-11-019110.1136/bmjgast-2021-000826Nimble Approach: fast, adapting, calculating and ethically mindful approach to managing colorectal cancer screening programmes during a pandemicNancy N Baxter0Arlinda Ruco1Jill Tinmouth2Catherine Dubé3Anne Sorvari4Linda Rabeneck5Natalie A Baker6Marcia Facey7Amina Benmessaoud86 Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, AustraliaUniversity of Toronto Institute of Health Policy Management and Evaluation, Toronto, Ontario, Canada2 University of Toronto Institute of Health Policy Management and Evaluation, Toronto, Ontario, CanadaCancer Care Ontario, Toronto, Ontario, CanadaSt. Michael`s Hospital/Unity Health Toronto, Toronto, Ontario, CanadaCancer Care Ontario, Prevention and Cancer Control, Ontario Health, Toronto, Ontario, CanadaSt Michael`s Hospital Li Ka Shing Knowledge Institute, Toronto, Ontario, CanadaSt Michael`s Hospital Li Ka Shing Knowledge Institute, Toronto, Ontario, CanadaLi Ka Shing Knowledge Institute, St Michael`s Hospital, Toronto, Ontario, CanadaObjective To describe a conceptual framework that provides understanding of the challenges encountered and the adaptive approaches taken by organised colorectal cancer (CRC) screening programmes during the initial phase of the COVID-19 pandemic.Design This was a qualitative case study of international CRC screening programmes. Semi-structured interviews were conducted with programme managers/leaders and programme experts, researchers and clinical leaders of large, population-based screening programmes. Data analysis, using elements of grounded theory, as well as cross-cases analysis was conducted by two experienced qualitative researchers.Results 19 participants were interviewed from seven programmes in North America, Europe and Australasia. A conceptual framework (‘Nimble Approach’) was the key outcome of the analysis. Four concepts constitute this approach to managing CRC screening programmes during COVID-19: Fast (meeting the need to make decisions and communicate quickly), Adapting (flexibly and creatively managing testing/colonoscopy capacity, access and backlogs), Calculating (modelling and actively monitoring programmes to inform decision-making and support programme quality) and Ethically Mindful (considering ethical conundrums emerging from programme responses). Highly integrated programmes, those with highly integrated communication networks, and that managed greater portions of the screening process seemed best positioned to respond to the crisis.Conclusions The Nimble Approach has potentially broad applications; it can be deployed to effectively respond to programme-specific challenges or manage CRC programmes during future pandemics, other health crises or emergencies.https://bmjopengastro.bmj.com/content/9/1/e000826.full
spellingShingle Nancy N Baxter
Arlinda Ruco
Jill Tinmouth
Catherine Dubé
Anne Sorvari
Linda Rabeneck
Natalie A Baker
Marcia Facey
Amina Benmessaoud
Nimble Approach: fast, adapting, calculating and ethically mindful approach to managing colorectal cancer screening programmes during a pandemic
BMJ Open Gastroenterology
title Nimble Approach: fast, adapting, calculating and ethically mindful approach to managing colorectal cancer screening programmes during a pandemic
title_full Nimble Approach: fast, adapting, calculating and ethically mindful approach to managing colorectal cancer screening programmes during a pandemic
title_fullStr Nimble Approach: fast, adapting, calculating and ethically mindful approach to managing colorectal cancer screening programmes during a pandemic
title_full_unstemmed Nimble Approach: fast, adapting, calculating and ethically mindful approach to managing colorectal cancer screening programmes during a pandemic
title_short Nimble Approach: fast, adapting, calculating and ethically mindful approach to managing colorectal cancer screening programmes during a pandemic
title_sort nimble approach fast adapting calculating and ethically mindful approach to managing colorectal cancer screening programmes during a pandemic
url https://bmjopengastro.bmj.com/content/9/1/e000826.full
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