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

02_ASGE Quality_Dominitz_Colonoscopy

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This document discusses quality indicators for colonoscopy, emphasizing the importance of measuring and improving colonoscopy quality. The author highlights the need for quality improvement in colonoscopy, as it is the most common endoscopic procedure in the US and has a significant impact on reducing colorectal cancer (CRC) incidence and mortality. The document presents various quality indicators in three domains: pre-colonoscopy, intra-colonoscopy, and post-colonoscopy. <br /><br />Notably, the document focuses on the adenoma detection rate (ADR) as the single most important quality measure in colonoscopy. The ADR is a direct correlation with CRC and is associated with a decreased risk of interval and fatal cancers. The target ADR is now set at >25% overall, >20% for women, and >30% for men. Other quality indicators discussed include cecal intubation with photodocumentation, appropriate surveillance recommendations, and withdrawal time. <br /><br />Challenges in quality measurement are acknowledged, such as the labor-intensive process, sample size implications, and the difficulty in measuring appropriate surveillance recommendations. Despite these challenges, the measurement of colonoscopy quality is considered the standard of care and can lead to improved outcomes. The document emphasizes the importance of reporting colonoscopy quality and recommends focusing on the "priority quality indicators" to ensure high-quality colonoscopy for all patients. The document concludes with practice pearls that highlight the need to measure and improve colonoscopy quality for better patient outcomes.

Keywords

quality indicators

colonoscopy

measuring

improving

adenoma detection rate

ADR

colorectal cancer incidence

cecal intubation

surveillance recommendations

withdrawal time