BMJ Qual Improv Report 6: doi:10.1136/bmjquality.u204560.w5376
  • BMJ Quality Improvement Programme

Improving bowel preparation for colonoscopy in a cost effective manner

  1. Clare Tibbatts
  1. Cardiff & Vale university health board, Wales, United Kingdom
  1. Correspondence to Syed Anjum Gardezi sanjliajk{at}
  • Received 16 June 2016
  • Revision requested 2 August 2016
  • Revised 10 March 2017
  • Published 17 May 2017


Colonoscopy is a key investigation used to exclude large bowel pathologies including surveillance for CRC (Colorectal cancer) Poor bowel preparation (bowel prep) is one of the most important factors affecting its diagnostic yield. Different formulations of bowel prep are currently in use depending upon patient tolerance, indication & co-morbidities. In University Hospital Llandough we retrospectively reviewed the outcome of colonoscopies performed over period of 3 months, in relation to the type and outcome of bowel preparations used. We implemented a change of patient instruction and pre-assessment of bowel preparation prescribed. We repeated the same measurements over 3 different cycles on 3 different occasions and compared the outcome.

We noticed that quality of bowel preparation noticeably improved from 80% to almost 93% if patients were given appropriate advice in a written format, prior to procedure. In addition to improvement in the quality of assessment & reducing the number of repeat procedures, by changing the bowel preparation product and postage methods we estimated savings of almost £150,000 for the trust in a year.

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