A LOOK INTO THE REPORTING OF PERFORMANCE MEASURES FOR LOWER GASTROINTESTINAL ENDOSCOPY FROM A TERTIARY REFERRAL CENTER FROM ROMANIA: ROOM TO IMPROVE

Aims:

Standardized reporting and formal quality benchmarking for lower gastrointestinal (GI) endoscopy are essential to ensure quality services but are currently deficient in Romania. We aimed to analyze data regarding quality in colonoscopy practices in a single referral center in order to identify areas which require oversight and improvement.

Methods:

This is a single-center retrospective analysis of colonoscopy practices in a teaching hospital in Bucharest. All colonoscopy reports from a 3-month period in our unit were analyzed for this study. The reccomended minimum standard according to the recent ESGE guideline for performance measures in lower GI endoscopy was used as reference for the following key measures: appropriate indication (≥85%), adequate quality of bowel preparation (≥90%), completeness of procedure (≥90%), adenoma (≥25%) and polyp detection rate (> 40%). Parameters that could not be inferred from a report were treated as missing data for that analysis and not included in the denominator.

Results:

During a 3 month period 310 colonoscopies were performed in our unit. The indication for colonoscopy was considered adequate in 78.7% cases, while the rate of adequate bowel preparation was 64.5% (not reported in 18.4% procedures) and the cecal intubation rate was 74.7% (not reported in 3.7%). The adenoma detection rate and the polyp detection rate for the service were 27.3% and 51.7%. The reintervention rate and 7-day readmission rate for complications were 0% during the study period. Several performance measures such as alloted time slot for endoscopy and withdrawal time could not be calculated due to a systematic lack of reporting at the service level.

Conclusions:

Suboptimal performance measures and a lack of systemic reporting were noted in this single-center retrospective analysis of colonoscopy practices. This reflects an unmet need to ensure standardized reporting of lower GI endoscopy procedures and improve performance measures on an institutional and national scale in developing countries.