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

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.