Original Article on Quality in Gastrointestinal Endoscopy
Monitoring of colonoscopy quality indicators in an academic endoscopy facility reveals adherence to international recommendations
Abstract
Background: We monitor colonoscopy service quality biannually, by measuring sedation administration, colonoscopy completion, adenoma detection and early complications rates (CR). We herein present our audit results for the years 2013 and 2015.
Methods: In our endoscopy facility, five rotating senior gastroenterologists perform colonoscopies, on a daily basis. We measured the quality indicators in three cohorts: A, intention for total colonoscopy cases; B, cohort A excluding bowel obstruction cases; C, colorectal cancer (CRC) screening cases.
Results: In 2015, overall sedation administration rate (SAR) was 93.0% (91.6–94.4%), achieving our target to give conscious sedation to >90% of patients undergoing colonoscopy in all three cohorts. Colonoscopy completion rate (CCR) increased significantly (P<0.0001) from 94.8% (93.4–96.2%) to 98.1% (97.3–98.9%) in cohort B and numerically from 96.6% (94.4–98.8%) to 98.6% (97.4–99.7%) in cohort C, at the same periods. In cohort C, adenoma detection rates (ADR) were similar—27.1% (21.7–32.5%) and 27% (22.7–31.3%)—in the two periods. There were only two serious early complications: one cardiorespiratory event and one perforation in 2013 and 2015, respectively. While significant variability regarding SAR (ranging from 80% to 100%) was detected among the participating endoscopists, all but one of them constantly achieved [judged by the lower confidence interval (CI) of the quality indicator] CCRs higher than the recommended by international guidelines. On the contrary ADR was variable among endoscopists during the studied periods.
Conclusions: Although there is certain variability in endoscopists’ performance, the overall colonoscopy quality indicators meet or exceed the internationally recommended standards, in our endoscopy facility.
Methods: In our endoscopy facility, five rotating senior gastroenterologists perform colonoscopies, on a daily basis. We measured the quality indicators in three cohorts: A, intention for total colonoscopy cases; B, cohort A excluding bowel obstruction cases; C, colorectal cancer (CRC) screening cases.
Results: In 2015, overall sedation administration rate (SAR) was 93.0% (91.6–94.4%), achieving our target to give conscious sedation to >90% of patients undergoing colonoscopy in all three cohorts. Colonoscopy completion rate (CCR) increased significantly (P<0.0001) from 94.8% (93.4–96.2%) to 98.1% (97.3–98.9%) in cohort B and numerically from 96.6% (94.4–98.8%) to 98.6% (97.4–99.7%) in cohort C, at the same periods. In cohort C, adenoma detection rates (ADR) were similar—27.1% (21.7–32.5%) and 27% (22.7–31.3%)—in the two periods. There were only two serious early complications: one cardiorespiratory event and one perforation in 2013 and 2015, respectively. While significant variability regarding SAR (ranging from 80% to 100%) was detected among the participating endoscopists, all but one of them constantly achieved [judged by the lower confidence interval (CI) of the quality indicator] CCRs higher than the recommended by international guidelines. On the contrary ADR was variable among endoscopists during the studied periods.
Conclusions: Although there is certain variability in endoscopists’ performance, the overall colonoscopy quality indicators meet or exceed the internationally recommended standards, in our endoscopy facility.
