Standardizing inpatient colonoscopy preparations improves quality and provider satisfaction.

Area of Science:

• Gastroenterology
• Quality Improvement Science
• Health Informatics

Background:

• Inpatient colonoscopy bowel preparation quality is often suboptimal, impacting procedure effectiveness.
• A quality improvement (QI) initiative was implemented to standardize and enhance bowel preparation processes.

Observation:

• A Define, Measure, Analyze, Improve and Control (DMAIC) methodology was used to identify root causes of poor bowel preparation.
• A standardized electronic health record (EHR)-based order set was developed with consistent instructions and provider guidance.

Findings:

• The QI intervention significantly improved the adequacy of right colon bowel preparations (75.0% vs 86.9%, p=0.04).
• While overall preparation quality did not significantly change, there were numerical improvements in diagnostic yield and reduced procedure abort rates.
• Provider satisfaction with the EHR ordering process significantly increased post-intervention (23.3% vs 61.1%, p<0.001).

Implications:

• Standardized EHR order sets can effectively improve specific aspects of inpatient colonoscopy preparation, particularly in the right colon.
• Enhanced provider satisfaction suggests that such standardized tools can positively impact the clinical workflow and user experience.
• This QI intervention demonstrates a successful strategy for improving colonoscopy quality and aligns with goals for better patient care and provider experience.