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Optimizing Large-Volume Paracentesis in a Gastroenterology Ward: A Two-Cycle Quality Improvement Project.

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Standardizing equipment preparation and documentation for large-volume paracentesis improved efficiency and consistency. This Quality Improvement Project (QIP) utilized checklists and electronic proformas to reduce delays and enhance trainee confidence.

Keywords:
ascitic draindocumentation improvementgastroenterologylarge-volume paracentesisprocedural efficiencyquality improvement

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Area of Science:

  • Gastroenterology
  • Medical Quality Improvement
  • Healthcare Operations

Background:

  • Delays in large-volume paracentesis preparation were common in a London hospital gastroenterology ward.
  • Difficulty in locating and gathering equipment contributed significantly to procedural delays.

Purpose of the Study:

  • To standardize equipment preparation for large-volume paracentesis.
  • To improve the perceived efficiency of the procedure.
  • To enhance post-procedure documentation quality and consistency.

Main Methods:

  • A two-cycle Quality Improvement Project (QIP) using the Plan-Do-Study-Act (PDSA) methodology.
  • Cycle one: Introduced a standardized equipment checklist poster to improve preparation.
  • Cycle two: Developed a smart text proforma in the electronic patient record for documentation.

Main Results:

  • The equipment checklist poster was perceived to reduce preparation time, with 83% of respondents reporting a decrease.
  • The smart text proforma improved documentation clarity and speed, with users anticipating reduced time per note.
  • Trainee confidence and consistency in documentation were enhanced.

Conclusions:

  • Standardized equipment checklists and smart text proformas effectively reduce procedural delays in large-volume paracentesis.
  • These interventions improve documentation consistency and trainee confidence.
  • The approach is adaptable to other departments and procedures with local refinement.