Quality in colonoscopy reporting: An assessment of compliance and performance improvement

Coe, Susan G.; Panjala, Chakri; Heckman, Michael G.; Patel, Mihir; Qumseya, Bashar J.; Wang, Yize R.; Dalton, Benjamin; Tran, Philip; Palmer, William; Diehl, Nancy N.; Wallace, Michael B.; Raimondo, Massimo

doi:10.1016/j.dld.2012.03.022

Cited by 20 publications

(13 citation statements)

References 14 publications

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“…In 2002 Robertson et al [ 10 ] found that 59% of reports in research-affiliated facilities included a procedure interpretation and plan. More recently at the Mayo Clinic, follow-up recommendations and screening intervals were found in only 81% of colonoscopy reports [ 24 ]. In addition to incomplete summaries and recommendations the procedural details provided are often insufficient to determine appropriate surveillance intervals [ 8 , 12 , 15 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…The previously cited study by Mai et al [ 23 ] from 1991 demonstrated that peer review through monthly quality assurance meetings reduced report deficiency rates from 91.6% to 33%, along with significant reduction in inappropriate indications for endoscopy. A more recent study was also able to achieve positive results through a 10-minute documentation completeness compliance rate review incorporated into their monthly staff meetings [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

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A Review on the Quality of Colonoscopy Reporting

Sharma

2016

Canadian Journal of Gastroenterology and Hepatology

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Colonoscopy reports are important communication tools for providers and patients with potential to serve as information sources for research, quality, performance, and resource management. Despite decades of work, studies continue to indicate that colonoscopy reports are often incomplete. Although electronic medical records (EMRs) and databases can address this problem, costs, workflow, and interoperability (difficulty exchanging information between systems) continue to limit adoption and implementation of endoscopy EMRs in Canada and elsewhere. Quality and reporting guidelines alone have proven to be insufficient. In this review we have derived and applied five key themes to challenges in the current state of colonoscopy reporting and propose strategies to address them.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Review on the Quality of Colonoscopy Reporting

Sharma

2016

Canadian Journal of Gastroenterology and Hepatology

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“…85 The intervention included lectures sharing baseline quality indicator compliance for recommended quality indicators. Individual compliance rates were also shared directly with endoscopists.…”

Section: Quality Improvement Initiativesmentioning

confidence: 99%

Colonoscopy Quality

Calderwood¹,

Jacobson²

2013

Gastroenterology Clinics of North America

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Synopsis Colonoscopy is an excellent area for quality improvement 1 because it is high volume, has significant associated risk and expense, and there is evidence that variability in its performance affects outcomes. The best endpoint for validation of quality metrics in colonoscopy is colorectal cancer incidence and mortality, but because of feasibility issues, a more readily accessible metric is the adenoma detection rate (ADR). Fourteen quality metrics were proposed by the joint American Society of Gastrointestinal Endoscopy/American College of Gastroenterology Task Force on “Quality Indicators for Colonoscopy” in 2006, which are described in further detail below. Use of electronic health records and quality-oriented registries will facilitate quality measurement and reporting. Unlike traditional clinical research, implementation of quality improvement initiatives involves rapid assessments and changes on an iterative basis, and can be done at the individual, group, or facility level.

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“…These assessment tools focus on technical performance and cognitive skills. Unfortunately, these are prone to observer bias and present a formidable workload for expert supervisors/ assessors, in turn reducing compliance [2,4,15,16]. Nerup et al developed a computerized assessment tool, the Colonoscopy Progression Score (CoPS) to allow an automatic and unbiased assessment of colonoscopy skills [17].…”

Section: Introductionmentioning

confidence: 99%

Using computerized assessment in simulated colonoscopy: a validation study

et al. 2020

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Background and study aims Patient safety during a colonoscopy highly depends on endoscopist competence. Endoscopic societies have been calling for an objective and regular assessment of the endoscopists, but existing assessment tools are time-consuming and prone to bias. We aimed to develop and gather evidence of validity for a computerized assessment tool delivering automatic and unbiased assessment of colonoscopy based on 3 dimensional coordinates from the colonoscope. Methods Twenty-four participants were recruited and divided into two groups based on experience: 12 experienced and 12 novices. Participants performed twice on a physical phantom model with a standardized alpha loop in the sigmoid colon. Data was gathered directly from the Olympus ScopeGuide system providing XYZ-coordinates along the length of the colonoscope. Five different motor skill measures were developed based on the data, named: Travel Length, Tip Progression, Chase Efficiency, Shaft movement without tip progression, and Looping. Results The experinced had a lower travel length (P < 0.001), tip progression (P < 0.001), chase efficiency (P = 0.001) and looping (P = 0.006), and a higher shaft movement without tip progression (P < 0.001) reaching the cecum compared with the novices. A composite score was developed based on the five measurements to create a combined score of progression, the 3D-Colonoscopy-Progression-Score (3D-CoPS). The 3D-CoPS revealed a significant difference between groups (experienced: 0.495 (SD 0.303) and novices –0.454 (SD 0.707), P < 0.001). Conclusion This study presents a novel, real-time computerized assessment tool for colonoscopy, and strong evidence of validity was gathered in a simulation-based setting. The system shows promising opportunities for automatic, unbiased and continuous assessment of colonoscopy performance.

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Quality in colonoscopy reporting: An assessment of compliance and performance improvement

Cited by 20 publications

References 14 publications

A Review on the Quality of Colonoscopy Reporting

A Review on the Quality of Colonoscopy Reporting

Colonoscopy Quality

Using computerized assessment in simulated colonoscopy: a validation study

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