How We Cleaned It Up: A Simple Method That Improved Our Practice’s Bowel Prep
Nalinee Srisarajivakul, MD; Deborah Chua, MD; Renee Williams, MD; Lyvia Leigh, MD; Amy Ou, BS; Giulio Quarta, MD; Michael A. Poles, MD, PhD; and Adam Goodman, MD, New York University Langone School of Medicine
Bellevue Hospital Center is a New York City public hospital that serves a high proportion of uninsured, underinsured, Medicaid patients and non-English speakers. Data collected on patients presenting to our suite show that ~46% have limited English proficiency, 29% are uninsured, and 32% have Medicaid. The primary languages spoken in our hospital other than English include Spanish and Chinese Mandarin. Review of our data showed that nearly 35% of our patients who undergo colonoscopy have an inadequate bowel preparation requiring repeat procedures. Improving bowel preparation in this setting is a challenge; however, we utilized elements of the Plan Do Study Act (PDSA) cycle to characterize the effect of split-dose preparation and the use of a multi-language educational booklet on bowel cleanliness in our high-risk patient population.