Moving the Needle on Patient Cancellations Through Mobile Integration: A Hospital-Based Quality Improvement Project.

Area of Science:

• Gastroenterology
• Health Informatics
• Quality Improvement

Background:

• Colonoscopy preparation, specifically NPO instructions, is crucial for procedure success.
• Failure to adhere to NPO guidelines is a primary cause of same-day colonoscopy cancellations.
• Standard reminder calls have limitations in ensuring patient adherence.

Purpose of the Study:

• To evaluate the impact of the Annie application (Annie app), a short message service (SMS), on same-day colonoscopy cancellation rates.
• To determine if SMS reminders improve adherence to nothing by mouth (NPO) instructions.
• To assess the effectiveness of the Annie app in a large hospital clinic setting.

Main Methods:

• A quality improvement project implemented the Annie app, providing timed educational SMS messages for colonoscopy preparation.
• Patients received standard 14-day and 3-day nurse reminder calls, with the Annie app as an additional intervention.
• Cancellation rates were compared between patients using the Annie app and those receiving only voicemail messages.

Main Results:

• Implementing the Annie app was significantly associated with reduced cancellation rates.
• A 21% decrease in same-day cancellations was observed in patients using the Annie app compared to voicemail-only.
• African American patients experienced the most significant benefit, with cancellations decreasing from 28.4% to 17.9%.

Conclusions:

• The Annie app effectively improves adherence to colonoscopy bowel preparation protocols.
• SMS-based interventions like the Annie app can significantly decrease same-day colonoscopy cancellations.
• The Annie app demonstrates particular efficacy in improving adherence among minority populations.