Improving Quality and Safety In Your Endoscopy Unit: On-Demand | October 2022 OLQUALOCT22-Round Table Discussion 1: Defining and Measuring Quality Endoscopy

Video Transcription

Video Summary

In this video, the first roundtable discussion begins with the question of whether the ADRs (Adenoma Detection Rates) are lower when colonoscopies are performed by or with fellows. The participants discuss that the ADRs depend on the quality of supervision and training, and how well the fellows are taught to detect polyps. They also mention that the polyp misrate for fellows decreases as they progress through their training. The discussion then moves onto the topic of FIT or Cologuard screening for adults with one to two small tubular adenomas. The participants acknowledge that there are no guidelines recommending FIT for this patient group, but some centers have started trials exploring this option. The next question is about how to scale quality improvement efforts for ASCs (Ambulatory Surgery Centers) with limited resources. The participants mention the importance of commitment from leadership in ASCs and the use of electronic health records and registries. They also discuss the potential benefits that ASCs can reap by demonstrating high-quality care, such as improved reimbursement and negotiated agreements with insurance companies. The final question is regarding the inclusion of serrated polyps in ADR calculations. The participants suggest that it is acceptable to lump serrated polyps with adenomas in the calculations, but caution that the benchmark should be adjusted accordingly. They emphasize the importance of accurately identifying serrated polyps and adenomas separately to avoid artificially inflating ADRs. The discussion concludes with a confirmation that a six-minute withdrawal time should be maintained for all colonoscopies, regardless of the reason for the procedure.

Keywords

ADR

colonoscopies

fellows

polyps

FIT