Improving Quality and Safety in the Endoscopy Unit (On-demand) | November 2025-Defining and Measuring Quality in Colonoscopy

Video Transcription

Video Summary

The lecture focuses on quality indicators for colonoscopy, emphasizing their critical role in reducing colorectal cancer incidence and mortality through high-quality procedures. Key priority indicators include adenoma detection rate (ADR), particularly the new broader measure encompassing screening, surveillance, and diagnostic colonoscopies with a target ADR of ≥35%, reflecting its strong link to lowering post-colonoscopy colorectal cancer (PCCRC). Other priority indicators are appropriate surveillance interval adherence (≥90%), bowel preparation adequacy (≥90%), cecal intubation rate (≥95%), and the cecal serrated lesion detection rate (≥6%). The speaker reviews interval cancers, mostly due to missed lesions or incomplete polyp removal, and highlights evidence supporting optimized surveillance intervals based on polyp burden and risk. Measuring appropriate surveillance intervals is challenging but essential to avoid under- or overuse. Additional indicators include withdrawal time (≥8 minutes) and documentation of polyp resection. Quality improvement methods like feedback report cards, training, advanced imaging technologies, and emerging AI tools are mentioned, though AI benefits on outcomes remain uncertain. The overarching message is that measuring and reporting these indicators drives improved quality and patient safety, with emphasis that low adenoma detection endangers patients but can be enhanced through measurement and feedback. The lecture underscores the importance of continuous quality monitoring to optimize colonoscopy effectiveness in colorectal cancer prevention.

Asset Subtitle

TR Levin, MD

Keywords

colonoscopy quality indicators

adenoma detection rate

colorectal cancer prevention

surveillance interval adherence

bowel preparation adequacy

cecal intubation rate

AI in colonoscopy