REVISITING REPORTING OF PERFORMANCE MEASURES FOR LOWER GASTROINTESTINAL ENDOSCOPY FROM A TERTIARY REFERRAL CENTER FROM ROMANIA: STILL A LONG WAY TO GO...

Aims:

Standardized reporting and quality benchmarking for colonoscopy are essential marks of a high-quality Endoscopic unit. We previously reported suboptimal key performance measures in colonoscopy practices in a single tertiary referral center. This is a reassessment of the key performance measures 6 months after announcing the results of the former audit to the colonoscopists in the unit.

Methods:

This is a single-center retrospective analysis of colonoscopy performance in a tertiary-referral center. All colonoscopy reports from a 3-month period were analyzed for this study, in identical fashion to the previous audit. Standard ESGE guideline recommendations for performance measures in lower GI endoscopy were used for the following key measures: indication (≥85%), quality of bowel preparation (≥90%), caecal intubation rate (≥90%), adenoma (≥25%) and polyp detection rate (> 40%).

Results:

During a 3-month period (1.03 – 31.05.2018) 278 colonoscopies were performed in our unit. Since the previous audit there was a noticeable improvement in the reported indication for colonoscopy which was adequate in 91.2% compared to 78.7% of cases in the initial audit. However, there was no improvement in the rate of adequate bowel preparation (63.8% vs. 64.5%) or cecal intubation rate (71.3% vs. 74.7%). The adenoma detection rate and the polyp detection rate for the service remained consistent and were 27% (vs 27.3%) and 49% (vs 51.7%).

Conclusions:

Some suboptimal key performance measures persisted after reporting the results of the previous audit. Further retraining and proper reporting of outcomes are mandatory for improvement of key performance measures and achieving reccomended quality standards in lower GI endoscopy.