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Assessing performance of colonoscopy procedures improves quality
Date:6/21/2013

re no financial incentives or penalties for achieving or not achieving preset targets. Third, the report cards are blinded to individual endoscopists, with minimal feedback administered confidentially as needed. Fourth, the intervention is administered regularly and relatively frequently, at 3-month intervals," said study lead author Charles J. Kahi, MD, MSCR, Indiana University School of Medicine and Roudebush Veterans Affairs Medical Center, Indianapolis. "We speculate that a combination of these factors led to the observed global improvement in the adenoma detection and cecal intubation rates, rather than a defined and measurable change in one discrete variable."

Methods

The American Society for Gastrointestinal Endoscopy introduced a quality recognition program in 2008 that recognizes endoscopy units that have implemented quality improvement and monitoring processes as an integral part of their operations. In 2009, the Roudebush Veterans Affairs Medical Center GI endoscopy unit in Indianapolis, was one of the first to receive this distinction. The transition to the new quality monitoring program occurred during the first three months of 2009. Subsequently, physicians who performed endoscopic procedures at the Medical Center started to receive quarterly "report cards," which provided data regarding colonoscopy quality indicators including documentation of bowel preparation quality, before-procedure patient assessment, cecal intubation, withdrawal time, and adenoma detection rate (ADR).

Data from six endoscopists were included. Patients were average-risk, aged 50 years or older, undergoing their first screening colonoscopy. The study time frame was July 1, 2008 to December 31, 2008 (before intervention) and April 1, 2009 to March 31, 2011 (intervention). The report card quality initiative was implemented gradually during the first few weeks of 2009. The primary outcomes were cecal intubation or the visualization of the cecum (the
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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