Award-winning GEO GE online platform halves poor bowel preparation rate and maintains sessile serrated adenoma detection rate in a high-performing metropolitan center

ABSTRACT

Background and Aim: Poor bowel preparation for colonoscopy leads to aborted procedures and reduced polyp and cancer detection rates, leading to increased risk for patients, inconvenience to families, and additional resource use in a burgeoning health care system. The UK's Joint Advisory Group on GI Endoscopy suggests that units have a > 90% rate of adequate preparation for successful accreditation. To improve patient education and poor preparation rates at our institution, the Project GEO - GE Online video platform was introduced in 2019. This consists of five Vimeo-hosted short educational videos to help prepare patients and their carers for their endoscopy and colonoscopy procedures, including diet and bowel preparation. We aimed to examine key performance indicators in colonoscopy, including bowel preparation, before and after the introduction of GEO. Method(s) We performed a retrospective audit in a metropolitan teaching hospital in Queensland that performs more than 6000 colonoscopies per year. A link to GEO, a set of culturally sensitive, patient-centered videos, was sent in a letter, an email, and SMS to patients preparing for endoscopy and colonoscopy. Previously, patients were required to attend the hospital and were given printed handouts for information. This audit obtained Provation MD data for a 6-month period in 2019, before the initiation of GEO, and a 6-month period after, in 2021. Incomplete colonoscopies or those without preparation reporting were excluded from the analysis. Statistics were performed with chi2 analysis, and significance was set as a P value of < 0.05. Result(s) In the 6 months of 2019, before the GEO videos, a total of 2798 colonoscopies were performed. After colonoscopies with missing data and incomplete procedures were removed, there were 2031 colonoscopies for analysis. A total of 2277 colonoscopies were included in the post-GEO dataset. Results for bowel preparation and sessile serrated adenoma (SSA) detection rate before and after GEO are shown in Table 1. Conclusion(s) Project GEO has shown a significant reduction in poor preparation rates in a high-performing center and reduced repeat procedures, while not compromising SSA detection rate. Poor preparation often leads to abandonment of procedures, waste of health resources, and significant risk and inconvenience for patients, carers, and the system provider. Project GEO has had excellent patient feedback that it is improving patient and carer education and understanding, is improving compliance, and is convenient. This has led to a massive reduction in face-to-face outpatient visits (> 10 000). GEO is also COVID-19-friendly, culturally sensitive, and reaches our patients in distant regional and rural Queensland.