Preparation, coached not issued
Contact at seven days, three days, the day before and the morning of: diet stages, when to start drinking, what the output should look like, and what to do if it has not started working.
Specialty · Gastroenterology
Nobody arrives for a scope unprepared again.
Endoscopy preparation coached end to end, IBD flare triage against your own criteria, biologic monitoring kept on schedule, and bleeding red flags checked on every contact.
- 76%
- Fewer cancellations for poor prep
- < 2 hrs
- Flare contact to clinical decision
- 97%
- Biologic monitoring on schedule
In the product
Endoscopy prep — list 14 March
CoachingOutbound 20:10, evening before · Hannah B. · 51 · colonoscopy 09:30 · Moviprep
Primum
You should have finished the first litre by now. How is it going?
Caller
I've drunk it all but nothing's happening. I'm starting to panic a bit.
Primum
That's more common than you'd think and it isn't a reason to cancel. Keep drinking clear fluids — water or clear apple juice — and start the second litre at half past ten rather than eleven. Most people start within the hour after that.
Prep delay logged · second dose rescheduled 22:30 · list coordinator notified
Primum
I'll text you at half past eleven to check. If there's still nothing by then, we'll speak to the unit before you travel.
Preparation record
- Procedure
- Colonoscopy · 09:30
- Regimen
- Moviprep · split dose
- Dose 1
- Complete, no effect yet
- Adjustment
- Dose 2 moved to 22:30
- Apixaban
- Held 48h — confirmed
- Escort
- Confirmed · partner
Re-check scheduled 23:30 · unit notified · slot protected
Overview
A wasted endoscopy slot is the most expensive phone call you never made.
- Preparation coached across several contacts, not handed over as a leaflet.
- Anticoagulant and diabetes medication holds confirmed and reconfirmed.
- Flare triage and biologic monitoring worked without using clinic capacity.
Bowel preparation is genuinely difficult to follow. It involves stopping medicines, changing diet days ahead, drinking something unpleasant on a precise schedule, and doing it all correctly enough that the list is not cancelled at the door. A leaflet handed over three weeks earlier does not carry that.
Primum coaches the preparation across the whole run-up: the diet change, the medication holds, the timing of each dose, the escort arrangement, and a check the evening before that it is actually going to plan. Alongside it, the specialty's other high-volume work — IBD flare triage, biologic monitoring, bleeding red flags — runs on the same protocols the clinic already uses.
Capabilities
The four things a gastroenterology list needs
One protects the list. The others protect the patients on it.
Medication holds confirmed
Anticoagulants, antiplatelets, iron, GLP-1 agonists and insulin adjustments checked against the procedure and the patient's own regimen, then confirmed again the day before.
Flare triage against your criteria
Stool frequency, blood, urgency, nocturnal symptoms, pain and systemic features scored against your own flare definition, with escalation for anything suggesting severe colitis.
Biologic monitoring on schedule
Pre-infusion bloods, TB screening, tolerability after each dose and infusion scheduling — kept on interval, because a missed cycle costs more than the call.
How it works
Three weeks of preparation, one successful scope
The contacts are spaced so each one lands when the instruction actually has to be followed.
- Arrives
- Decided
- Done
- Returned
01
Procedure booked
Preparation regimen, medication holds and escort requirements determined from the procedure, the indication and the patient's own medication list.
Regimen selected
02
Holds confirmed
Anticoagulation and diabetes medication plans agreed against the record, and any conflict routed to the prescriber before the week of the procedure.
Med rec
03
Preparation coached
Staged contacts covering diet, dosing times and what to expect, in the patient's own language, with re-instruction if something has gone wrong.
4-contact schedule
04
Verified and cleared
A check the evening before confirming preparation is working and the escort is arranged, with the list told in advance about anybody unlikely to be ready.
Pre-list report
01
Procedure booked
Preparation regimen, medication holds and escort requirements determined from the procedure, the indication and the patient's own medication list.
Regimen selected
02
Holds confirmed
Anticoagulation and diabetes medication plans agreed against the record, and any conflict routed to the prescriber before the week of the procedure.
Med rec
03
Preparation coached
Staged contacts covering diet, dosing times and what to expect, in the patient's own language, with re-instruction if something has gone wrong.
4-contact schedule
04
Verified and cleared
A check the evening before confirming preparation is working and the escort is arranged, with the list told in advance about anybody unlikely to be ready.
Pre-list report
Benefits
The list runs, and the flares are caught
Endoscopy capacity is the scarcest thing in this specialty.
Slots stop being wasted
Cancellations for inadequate preparation are almost entirely preventable with contact at the right moments. Each one recovered is a patient off the waiting list.
Flares are graded, not queued
A patient with six bloody stools a day and nocturnal symptoms is not the same as one with looser stools, and they stop waiting in the same queue.
Biologic cycles hold
Monitoring and infusion scheduling kept on interval protects both the response and the cost of a therapy nobody wants to restart.
In practice
Four gastroenterology contacts
Two protect a slot, two protect a patient.
Prep not working, 21:40
RescuedNothing happening three hours after the first dose. Re-instructed on volume and timing, and the list is flagged for a later position.
Apixaban before colonoscopy
Hold plan confirmedHold timing set against renal function and the polypectomy risk, agreed with the prescriber and confirmed the day before.
Ulcerative colitis, 8 stools
Same-day escalationBlood, nocturnal symptoms and tachycardia reported. Severe colitis criteria met and the IBD team is contacted immediately.
Melaena reported in passing
Emergency adviceThe caller rang about a repeat prescription. Black tarry stool is mentioned, the bleeding pathway opens and they are told to attend.
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Count your cancelled slots
Ask the unit how many procedures last quarter were abandoned for inadequate preparation. We will run the coaching schedule against one list and you can compare.