Minor performance measure	Proper instructions for bowel preparation
Description	Percentage of patients receiving bowel preparation instructions appropriately
Domain	Pre-procedure
Category	Process
Rationale	The giving of proper instructions for bowel preparation before DAE improves small-bowel mucosal visualization and ensures a safe procedure. Inadequate bowel preparation results in increased costs and inconvenience due to the need for a repeat DAE or alternative investigation. The quality of bowel preparation should be included in the report
Construct	Denominator: Patients undergoing DAE Numerator: Patients in the denominator receiving proper bowel preparation instructions: ▪ For antegrade DAE: – fasting for solids for at least six hours prior to the procedure – patients are allowed to drink water until two hours prior to the procedure ▪ For retrograde DAE: – same regimen of preparation as recommended by ESGE guidelines for colonoscopy (polyethylene glycol-based regimens of preparation) Exclusions: Emergency DAE, patients with ongoing bleeding Calculation: Proportion (%) Level of analysis: Service and individual level Frequency: Yearly and/or for a sample of 100 DAEs
Standards	Minimum standard: ≥95% Target standard: ≥95% If the minimum standard is not reached, analysis of the factors that influence proper information about bowel preparation (information given to patients, dietary restrictions, fasting, cleansing agents used, timing) should be performed on a service level After evaluation and adjustment, close monitoring should be performed with a further audit within 12 months
Consensus agreement	91.6%
PICO number	2 (see Supporting information, DAE file)
Evidence grading	Low-quality evidence