Background: Some patients lack the functional capability or social support to perform their own colonoscopy bowel preparation. These patients may be admitted to Inpatient units for support with the bowel preparation, but this process can be costly, lead to long lengths of stay, and decrease the admitting capacity of the hospital. An observation unit may be more appropriately staffed and equipped to prepare these patients.
Methods: This study employed retrospective chart review to compare patient-centered outcomes data between patients prepared using a standardized protocol in an observation unit and patients prepared on inpatient units. Patients were selected using inclusion criteria of age 18 or older with an ICD.10 code of z12.11 (screening colonoscopy for colon cancer). Three 16-month cohorts were assembled: a pre-observation unit cohort (patients ONLY admitted to inpatient units) and two post-intervention cohorts – patients admitted to either an inpatient unit or the observation unit.
Results: The average length of stay for the observation unit cohort (31.24 hours) was approximately 10h shorter than the pre- and post-intervention inpatient cohorts (41.48 hours and 43.81 hours, respectively). Patients placed in the observation unit significantly (p < .05) more visits under 35 hours compared to the post-intervention inpatient cohort. There were also trends toward improvement in preparation quality and decreased need for repeat preparation.
Conclusions: While this patient population has an overall longer length of stay than is typical for an observation unit, given the decrease in length of stay and impact on hospital admitting capacity, these patients may be best served in an observation unit.