Review Your Bowel Preparation Program Regularly

Review Your Bowel Preparation Program Regularly

Douglas K. Rex, MD, MASGE, reviewing Shaukat A. Gastrointest Endosc 2022 Aug 16.

In an article published by Gastrointestinal Endoscopy in its new Top Tips section, Shaukat reviews methods to improve bowel preparation in the endoscopy unit:

  • Map the bowel preparation process in the unit so that the content (what) and the process (who, how) are clearly delineated and responsibilities are assigned.
  • Offer multiple preparations. Using a single preparation is most efficient, but offering multiple preparations enhances satisfaction for patients who previously had poor tolerance of a specific preparation, and allows adjustments for patients with high copays for certain preparations.
  • Use clear instructions written at a sixth grade reading level, ideally no more than 1 to 2 pages, and favor pictures and embedded video links over verbiage.
  • Provide instructions using multiple modalities, such as paper plus electronic (email), and consider video links, QR codes, website links, or text messages.
  • Include preparation education in the preprocedure phone call. This call should occur 2 to 7 days before the procedure, and try to reach patients at different times of the day over 2 to 3 days. Consider automated phone calls or outsourcing to digital platforms using text-based bowel preparation education and instruction.
  • Have instructions in multiple languages if appropriate.
  • Measure bowel preparation adequacy at least quarterly and identify areas for improvement.
  • Seek intermittent feedback from patients.
  • Periodically review preparation regimens, instructions, and processes for inclusion of information about low-volume preparations, low-residue diets the day before colonoscopy, up-to-date anticoagulation and antiplatelet instructions, and identified wholesale or low-cost pharmacies to reduce patients’ costs.

Douglas K. Rex, MD, FASGE

COMMENT

These are important considerations relevant to outpatient endoscopy units seeking to maximize efficiency and patient satisfaction and to minimize costs to patients and health systems.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

CITATION(S)

Shaukat A. Organizing effective bowel preparation in the endoscopy unit. Gastrointest Endosc 2022 Aug 16. (Epub ahead of print) (https://doi.org/10.1016/j.gie.2022.08.016)

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