Improving Quality and Safety in the Endoscopy Unit (On-Demand) | August 2023-02_ASGE Quality_Dominitz

02_ASGE Quality_Dominitz_Colonoscopy

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This document written by Dr. Jason Dominitz provides an overview of quality indicators for colonoscopy procedures. The author emphasizes the importance of measuring and improving colonoscopy quality, as it is the most common endoscopic procedure in the US and is associated with reduced colorectal cancer (CRC) incidence and mortality. The author presents various quality indicators that can be used to assess the different stages of colonoscopy: pre-colonoscopy, intra-colonoscopy, and post-colonoscopy. These indicators include appropriate indication documentation, adequate bowel preparation, cecal intubation with photodocumentation, and detection of adenomas in average-risk individuals.<br /><br />The author discusses the significance of interval cancers, which are cancers that develop between colonoscopy screenings. He highlights the reasons why interval cancers occur and emphasizes the need for high-quality colonoscopies to minimize their occurrence. The author provides data on the frequency of interval cancers, which range from 3.4% to 8.6% within 6-36 months after colonoscopy.<br /><br />The document also discusses the challenges in measuring colonoscopy quality indicators. It mentions the importance of measuring the adenoma detection rate (ADR) as a key quality measure, but also acknowledges the challenges in determining the appropriate definition and measurement of ADR. The document emphasizes the need for robust quality measurement systems and the use of automated tools and auditing processes to improve the accuracy and efficiency of measurement.<br /><br />Overall, this document underscores the importance of measuring and improving colonoscopy quality to enhance patient outcomes. It provides an overview of the key quality indicators for colonoscopy and highlights the challenges associated with their measurement. The author emphasizes the role of healthcare providers and practices in implementing quality improvement strategies and monitoring performance to ensure high-quality colonoscopy procedures.

Keywords

quality indicators

colonoscopy procedures

measuring colonoscopy quality

colorectal cancer incidence

colorectal cancer mortality

pre-colonoscopy indicators

intra-colonoscopy indicators

post-colonoscopy indicators

interval cancers

adenoma detection rate