Improving Inpatient Colonoscopy Bowel Preparation: A Successful Quality Improvement Project

Area of Science:

• Gastroenterology
• Health Informatics
• Quality Improvement

Background:

• Inadequate inpatient bowel preparation for colonoscopy leads to repeat procedures, extended hospital stays, and increased costs.
• Standardized protocols are crucial for optimizing colonoscopy success rates and patient outcomes.

Purpose of the Study:

• To evaluate the effectiveness of a novel electronic medical record (EMR)-based order set for inpatient bowel preparation.
• To improve the quality of bowel preparation, reduce procedure delays, and shorten hospital stays for inpatient colonoscopies.

Main Methods:

• A nonrandomized intervention study comparing a new EMR bowel preparation order set (intervention group) with existing orders (control group).
• Evaluation of 459 inpatient colonoscopies over 16 months using the Boston Bowel Preparation Scale and analysis of procedure delays and length of hospital stay.

Main Results:

• The intervention group demonstrated a statistically significant improvement in Boston Bowel Preparation Scale scores compared to the control group.
• Adequate bowel preparations increased from 77% to 86% in the intervention group.
• The intervention group experienced a decreased length of hospital stay.

Conclusions:

• An EMR-based, standardized bowel preparation order set is an effective, low-cost, and sustainable method to improve inpatient colonoscopy preparation.
• This quality improvement initiative offers a practical solution for widespread hospital implementation to enhance procedural efficiency and patient care.