Improving Quality and Safety In Your Endoscopy Unit: On-Demand | October 2022 OLQUALOCT22-02_Levin_Colonoscopy

02_Levin_Colonoscopy _Updated

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This document discusses quality indicators for colonoscopy, their importance, and challenges in measuring colonoscopy quality. The author emphasizes that high-quality colonoscopy should be the expectation for all patients. The document highlights the need for quality improvement in colonoscopy due to its common usage and the significant impact it has on reducing colorectal cancer (CRC) incidence and mortality. The variable performance of endoscopists and the associated variation in effectiveness underscore the need to define elements of high-quality endoscopy and develop evidence-based quality measures and indicators.<br /><br />The document outlines quality indicators common to all gastrointestinal endoscopic procedures, including pre-colonoscopy, intra-colonoscopy, and post-colonoscopy indicators. It emphasizes the importance of measuring quality indicators such as appropriate surveillance intervals, adequacy of bowel preparation, cecal intubation with photodocumentation, and adenoma detection rate (ADR). The ADR is highlighted as the single most important quality measure in colonoscopy, as it directly correlates with CRC risk.<br /><br />The document also discusses updates in colonoscopy surveillance recommendations, emphasizing the importance of surveillance colonoscopy at appropriate intervals based on findings during the procedure. It highlights the changes in recommendations for patients with tubular adenomas, serrated polyps, and advanced adenomas.<br /><br />Improving colonoscopy quality is discussed, including the role of feedback, training, and technology in enhancing performance. The document concludes by emphasizing that despite challenges in measuring quality, it is essential to do so. Public reporting of ADR and the use of quality reporting tools are mentioned as ways to encourage improvement in colonoscopy quality.<br /><br />In summary, this document highlights the importance of quality indicators in colonoscopy, the benefits of measuring and improving colonoscopy quality, and the challenges involved in doing so. It emphasizes the need for high-quality colonoscopy, particularly in terms of appropriate indication, adenoma detection, cecal intubation, and surveillance recommendations.

Keywords

quality indicators

colonoscopy

measuring colonoscopy quality

high-quality colonoscopy

colorectal cancer incidence

colorectal cancer mortality

endoscopists

evidence-based quality measures

pre-colonoscopy indicators

intra-colonoscopy indicators