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Table 1 Recommendations for Communication

From: Perspectives of primary care providers and endoscopists about current practices, facilitators and barriers for preparation and follow-up of colonoscopy procedures: a qualitative study

Patient as the focus of communication
Time of referral - Primary Care Provider Scheduling procedure - Central Intake or consultant’s office Day of colonoscopy - Endoscopist Post-procedure - Endoscopist
Step 1: Identify reason for referral and confirm reason is an indication for referral Step 1: Schedule procedure or consultation appointment Step 1: Review informed consent and answer any questions Step 1: Review findings and determine patient follow-up for any clinically significant findings from pathology report (that will arrive later)
Inform provider and patient of findings and recommendations
Step 2: Identify care pathway, i.e., direct to scope or consultation with the endoscopist Step 2: Provide written information to patient about colonoscopy benefits and risks and specific bowel preparation
Provide copy of consent form
Provide supplemental web and/or video information if available
Step 2: Complete colonoscopy procedure Step 2: Clarify responsibility for arranging recommended follow-up (including recommended repeat colonoscopy) – primary care provider, endoscopist, and /or patient.
Step 3: Review recommendation with patient including reason for referral and care pathway
Provide written, patient-friendly information about colonoscopy, risks and benefits, and preparation for colonoscopy or about consultation with specialist
Step 3: Confirm appointment about one week in advance of date
Provide information concerning cancellation and resources for questions about preparation and procedure as well as a reminder to patient to review information
Step 3: Provide written information about findings to patient and forward report to primary care provider; information includes comments about samples sent to pathology
Inform patient and provider about recommended follow-up that may be modified based on any significant pathology findings
Schedule follow-up appointment, if necessary
 
Step 4: Obtain patient consent for referral   Step 4: Provide post-procedure instructions in writing to patient and person accompanying the patient  
Step 5: Complete standard referral form identifying priority or urgency
Document any special patient-specific needs (e.g., travel, language, other assistance)