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Just Measuring Quality Improves Colonoscopy Performance

Summary and Comment |
July 1, 2013

Just Measuring Quality Improves Colonoscopy Performance

  1. Douglas K. Rex, MDAU061

Adenoma detection and cecal intubation rates increased after implementation of a quarterly report card intervention.

  1. Douglas K. Rex, MDAU061

Previous study findings are mixed regarding whether the simple process of measuring quality in colonoscopy leads to improvement in performance (Clin Gastroenterol Hepatol 2009; 7:1335; Gastrointest Endosc 2010; 71:1253). In the current study, researchers retrospectively assessed whether a quarterly report card intervention improved performance measures of adenoma detection rate (ADR) and cecal intubation rate in a group of six gastroenterologists at a U.S. Veterans Affairs medical center.

The clinicians performed screening colonoscopies in 928 patients at average risk for colorectal cancer (mean age, 59.8; 93% male; 78% white) during a 6-month pre-intervention period (336 colonoscopies) and a two-year intervention period (592 colonoscopies). From the pre-intervention period to the intervention period, the adenoma detection rate increased from 44.7% to 53.9% (P=0.013) and the cecal intubation rate increased from 95.6% to 98.1% (P=0.027), with a higher ADR trend observed in five of the six physicians. Most of the increase in the overall ADR was attributable to an increase in detection of proximal colon adenomas.

Comment

Although this effect has not been observed in all clinical studies, these results are encouraging with regard to the positive impact of the measurement process itself on the quality of colonoscopy performance.

  • Disclosures for Douglas K. Rex, MD at time of publication Consultant / Advisory board Exact Sciences; Ferring Pharmaceuticals; Given Imaging; Olympus Speaker’s bureau Boston Scientific; Braintree; Ferring Pharmaceuticals Grant / research support Battelle; Braintree; Northwestern University; Olympus America Editorial boards Annals of Gastroenterology and Hepatology; Comparative Effectiveness Research; Expert Review of Gastroenterology and Hepatology; Gastroenterology; Gastroenterology and Hepatology News; Gastroenterology Report; Gastroenterology Research and Practice; Journal of Clinical Gastroenterology; Techniques in Gastrointestinal Endoscopy; World Journal of Gastroenterology; World Journal of Gastrointestinal Oncology; World Journal of Gastrointestinal Pathophysiology; World Journal of Gastrointestinal Pharmacology and Therapeutics

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