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Related Experiment Video

Updated: Feb 14, 2026

Structured Approach to Colonoscopy Technique Optimization: A Single-Center Experience with Novice Endoscopists
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Using the plan-do-study-act approach to improve inpatient colonoscopy preparation.

Sardar Musa Shah-Khan1, Jeremy Cumberledge2, Gorman Joel Reynolds2

  • 1Department of Medicine, West Virginia University, Morgantown, West Virginia, USA.

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|February 14, 2018
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Summary

Improving inpatient colonoscopy preparation is crucial. A quality improvement project successfully reduced poor colonoscopy preparations from 19% to 4% through staff education, standardized electronic orders, and patient handouts.

Keywords:
hospital medicinepdsaquality improvementquality improvement methodologies

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Area of Science:

  • Gastroenterology
  • Quality Improvement
  • Healthcare Management

Background:

  • Poor inpatient colonoscopy preparations present significant challenges for healthcare providers and patients.
  • Inadequate bowel preparation can lead to procedure difficulties, repeat examinations, increased costs, prolonged hospital stays, and reduced patient satisfaction.

Purpose of the Study:

  • To decrease the incidence of poor inpatient colonoscopy preparations.
  • To enhance the quality of colonoscopy procedures and patient outcomes through a structured quality improvement initiative.

Main Methods:

  • A plan-do-study-act (PDSA) approach was employed for quality improvement.
  • An intervention program included direct staff education, implementation of an electronic medical record (EMR) order set, and patient education handouts.
  • Inpatient colonoscopies performed between November 2016 and January 2017 were assessed for preparation quality.

Main Results:

  • The baseline rate of poor inpatient colonoscopy preparations was identified as 19%.
  • Following the multiphase intervention, the rate of poor preparations decreased to 4% over a subsequent 3-month period.
  • The implementation of an electronic order set within the EMR demonstrated the most significant impact on improving preparation quality.

Conclusions:

  • A multiphase intervention program effectively reduced poor inpatient colonoscopy preparations.
  • Standardizing the ordering process via electronic medical record (EMR) order sets is a key factor in improving colonoscopy preparation quality.
  • The described interventions are replicable at other institutions to improve patient outcomes and reduce healthcare costs.