Improving documentation of anticoagulation and antiplatelet recommendations after outpatientendoscopy.
Brendon O'ConnellAmanda BoydDarshan KothariNeena MillerJennifer CornejoBrian A SullivanPublished in: BMJ open quality (2023)
Clear documentation of instructions for resuming anticoagulant and antiplatelet (AC/AP) medications after gastrointestinal endoscopy is essential for high-quality postprocedure care. Yet, these recommendations are frequently absent, which may impact patient safety. We aimed to improve documentation of postprocedural AC/AP instructions through targeted interventions during outpatient endoscopy at a Veterans Affairs Medical Center using validated Quality Improvement methodology. We identified patients on AC/AP agents presenting for outpatient oesophagogastroduodenoscopy or colonoscopy and found restart recommendations were documented in only 59.4% of procedures at baseline. After two intervention cycles, which included provider education, nursing prompts and alterations to endoscopic documentation software, postprocedure documentation increased by 26.7%-86.1% when compared with baseline (p<0.001). These interventions, which require low-resource utilisation, could be part of standardised processes readily implemented at other institutions to help potentially reduce postprocedure patient confusion, medication errors and complications.
Keyphrases
- quality improvement
- patient safety
- electronic health record
- advance care planning
- healthcare
- transcription factor
- end stage renal disease
- clinical practice
- adverse drug
- venous thromboembolism
- newly diagnosed
- ejection fraction
- chronic kidney disease
- case report
- atrial fibrillation
- physical activity
- primary care
- palliative care
- emergency department
- small bowel
- peritoneal dialysis
- chronic pain
- drug delivery