MONITORING OF COLONOSCOPY QUALITY INDICATORS REVEALS ADHERENCE TO ESGE GUIDELINE IN AN ACADEMIC ENDOSCOPY FACILITY

Aims:

We monitor colonoscopy service quality biannually, by measuring sedation administration, colonoscopy completion, adenoma detection and early complications rates, in our endoscopy facility. We herein present our audit results for the years 2013 and 2015.

Methods:

Five rotating senior gastroenterologists perform colonoscopies, on a daily basis. We measured the quality indicators in three cohorts: A. intention for total colonoscopy cases; B. cohort A excluding bowel obstruction cases; C. Colorectal cancer screening cases.

Results:

In 2015, sedation administration rate was 93.0 (91.6 – 94.4)% in cohort A, thus achieving our target to give conscious sedation to > 90% of patients undergoing colonoscopy; this target was reached in all three cohorts. Colonoscopy completion rate increased significantly (p < 0.0001) from 94.8 (93.4 – 96.2)% to 98.1 (97.3 – 98.9)% in cohort B and numerically from 96.6 (94.4 – 98.8)% to 98.6 (97.4 – 99.7)% in cohort C at the same periods. In cohort C, adenoma detection rates were similar -27.1 (21.7 – 32.5)% and 27 (22.7 – 31.3)%- in the two periods. There were only two serious early complications: one cardiorespiratory event and one perforation in 2013 and 2015, respectively. While significant variability regarding sedation administration rate (ranging from 80% to 100%) was detected among the participating endoscopists, all but one of them constantly achieved (judged by the lower confidence interval of the quality indicator) colonoscopy completion rates higher than the recommended by ESGE guideline. On the contrary, only one endoscopist constantly met the target of adenoma detection rate during the studied periods.

Conclusions:

Although there is certain variability in endoscopists’ performance, the overall colonoscopy quality indicators meet or exceed the ESGE recommended standards, in our endoscopy facility.