Quality Improvement of Bowel Preparation for Screening Colonoscopies: A Study of Hospital Team Resource Management in Taiwan

Abstract

Background and Objectives: This study aimed to investigate the impact of patient education using a medical team resource management (TRM) method on the adequacy of bowel preparation. Methods: The study setting was a single hospital in northern Taiwan, and a total of 2104 (884 female, 1220 male) healthy subjects who underwent a health checkup colonoscopy screening were enrolled before and after the application of the TRM program intervention. The efficacy of the TRM intervention and the factors affecting bowel preparation were estimated using multivariate logistic regression. Results: The prevalence of adequate bowel preparation improved significantly from the preintervention period to the postintervention and validation periods, which had prevalence of 79.0%, 81.3%, and 84.0%, respectively. Using the preintervention period prevalence as a reference, the adjusted odds ratios (aORs) for adequate bowel preparation in the postintervention and validation periods were 2.199 (95% confidence interval [CI]: 1.538-3.142) and 2.035 (1.525-2.716), respectively. Men had a lower probability of adequate cleansing than women (aOR = 0.757; 95% CI = 0.598-0.957), and purgative containing polyethylene glycol had a lower probability of adequate cleansing than purgative containing sodium phosphate (aOR = 0.366; 95% CI: 0.277-0.483). Conclusions: Bowel preparation quality for colonoscopy could be improved by enhancing patient education via TRM, and we suggest that effective quality improvement schemes should be proposed for health-screening programs.

Data analysis of ambient intelligence in a healthcare simulation system: a pilot study in high-end health screening process improvement

“…This study plotted a cause-and-effect diagram (Fig. 2) to determine several important factors (marked as **) resulting in prolonged waiting times to investigate further the main causes of the prolonged waiting times of customers and formulate improvement measures, after full discussions with IE experts, physicians, nurses, and administers based on the Team Resource Management (TRM) methodology [23] and the suggestions provided by professional process improvement teams. The factors included the late arrival of customers, insufficient medical and nursing manpower at bottleneck stations, and different types of health examinations.…”