Proposed Topic (Most preferred): :
Enhancing Partnership with Patients and Community (Projects initiated to engage patients / carers / community to improve efficiency / quality of care)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
Li MY(1), Wong KY(1), Yung KM(1), Yuen SC(1), Lo HK(1), Chung YF(1), Or KM(1), Lau SY(1)
Affiliation :
(1) Department of Surgery, United Christian Hospital
Introduction :
A notable number of surgical patients undergoing colonoscopy in United Christian Hospital (UCH) defaulted their scheduled appointment due to forgetfulness or refusal of the procedure. Additionally, cancellations often result from poor compliance with bowel preparation and the inadvertent continuation of medications such as anticoagulants and antidiabetic agents. To address these challenges, a Telephonic Nurse Guidance initiative was implemented.
Objectives :
To evaluate the effectiveness of Telephonic Nurse Guidance for colonoscopy in reducing non-attendance and cancellations related to poor compliance.
Methodology :
A study with pretest-posttest design was carried out.
Nurses identified eligible patients, who were scheduled for colonoscopy, from the Clinical Management System (CMS). Those patients were contacted telephonically a week prior to their procedure. Nurses personalized each patient’s needs and reminded the patients of their appointment and instructed on bowel-preparation and medication withholding. Additional support, including replenishment of medications for drug loss, face-to-face education and clarifications with doctors were arranged as required. Concerns or questions from the patients were addressed.
The primary outcome measures were rates of non-attendance and cancellations due to poor compliance that defined by doctor in the Electronic Patient Record system (EPR). We compared these rates from EPR between the 4 months pre-intervention (1/12/22 – 31/3/23) and the 7 months post-intervention (1/4/23 – 31/10/23) periods.
Result & Outcome :
During the four months prior to the implementation of telephonic guidance (1/12/22 to 31/3/23), out of 377 inpatients scheduled for colonoscopy, there were 59 defaults (16%) and 31 cancellations due to poor compliance (8%). Following the introduction of telephonic guidance (1/4/23 to 31/10/23), among 588 inpatients, total of 52 patients did not answer the guidance call, the default rate decreased to 4% (24 patients, with 23 of these being individuals who did not answer the guidance call) and the cancellations rate due to poor compliance dropped to 0.7% (4 patients).
The result indicated that telephonic nurse guidance for colonoscopy was effective as it can reduce non-attendance and poor compliance related cancellation. Also, it can enhance patient’s adequate preparation for colonoscopy and ensure the continuity of care. Hence, it has become the standard practice in surgical department, UCH.
