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Colorectal cancer (CRC) screening saves patient suffering and health system expenses if the pathology is found in its early stages. Utilizing rapid process improvement cycles, the purpose of this paper is to improve the rate of CRC screening in a rural community in the USA.

Data were gathered from the authors’ electronic medical record. Non provider staff were trained to do the majority of the work utilizing population health, clinic visit checklists, and standard work. The two tests used were colonoscopy and fecal immunochemical test testing.

Dramatic improvement in the rates of colorectal screening were achieved. The base rate of documented CRC screening was 22 percent, with the rate two years later being 62.7 percent.

This work is of interest to those working in primary care, gastroenterology, general surgery, or if interested in designing standard work.

THE Manchester School of Librarianship was founded in October 1946, one of the original five schools opened in the autumn of that year. It was attached to the Department of Industrial Administration in the Manchester College of Science and Technology and was thus something of an exception, as the majority of schools of librarianship were attached to Colleges of Commerce or general Colleges of Further Education. As accommodation was very limited in this rapidly expanding college, the then City Librarian of Manchester, Charles Nowell, kindly offered the use of two rooms in the Central Library, so after a brief period in the College building, the students were moved to the Central Library, though the School remained administratively a part of the College. Many former students must have memories of those two curving rooms, the Manchester Room and the Lancashire Room, with their old‐fashioned school desks.

Megachurches represent an interesting empirical and conceptual phenomenon. Empirically, megachurches (Protestant churches with average weekly attendance of greater than 2,000 members) are growing at a time when overall church participation in the United States is steady or declining. Conceptually, megachurch pastors can be viewed as institutional leaders who attempt to reconcile new technologies and large congregations within a highly institutionalized setting. While many of these megachurches have a denominational affiliation, some do not. In this essay, we describe the literature on megachurches and offer observations about the megachurch as an institution. Drawing from preliminary analysis of a sample of over 1,400 megachurches (identified from the Hartford Institute for Religious Research), we also draw tentative conclusions about the characteristics of the pastors of megachurches, and one growing institutional maintenance practice: writing texts. We propose that examining megachurches can help extend the current research on institutional leadership, institutional work, and institutional support mechanisms.