Revision of Quality Indicators for the Endoscopy Quality Improvement Program of the National Cancer Screening Program in Korea

Abstract

Gastroscopy and colonoscopy are widely used for the early diagnosis of stomach and colorectal cancer. The present revision integrates recent data regarding previous quality indicators and novel indicators suggested for gastroscopy and colonoscopy procedures for the National Cancer Screening Program in Korea. The new indicators, developed by the Quality Improvement Committee of the Korean Society for Gastrointestinal Endoscopy, vary in the level of supporting evidence, and most are based solely on expert opinion. Updated indicators validated by clinical research were prioritized, but were chosen by expert consensus when such studies were absent. The resultant quality indicators were graded according to the levels of consensus and recommendations. The updated indicators will provide a relevant guideline for high-quality endoscopy. The future direction of quality indicator development should include relevant outcome measures and an evidence-based approach to support proposed performance targets.

Colonoscopy quality in community hospitals and nonhospital facilities in Korea

“…In Korea, the National Cancer Screening Program (NCSP) provides fecal occult blood testing for adults 50 years of age or older and colonoscopies for positive cases [26]. For endoscopy quality management, NCSP operates an Endoscopy Quality Improvement Program, and revised quality indicators were recently published by the KSGE [11]. Quality indicators consist of 34 items in six areas of the workforce, process, facilities and equipment, outcome, reprocessing, and sedation [11].…”

“…For endoscopy quality management, NCSP operates an Endoscopy Quality Improvement Program, and revised quality indicators were recently published by the KSGE [11]. Quality indicators consist of 34 items in six areas of the workforce, process, facilities and equipment, outcome, reprocessing, and sedation [11]. However, endoscopy quality evaluation criteria only assess the overall quality of the institution, not the performance indicators of the individual endoscopist.…”

“…Colonoscopy is now widely used in various clinical practice settings not only in academic medical centers, but also in community hospitals and nonhospital facilities. In Korea, the National Endoscopy Quality Improvement Program exists for colonoscopy quality control [11]. However, little is known regarding the substantive quality of colonoscopy in real-life practice settings.…”

Endoscopy training in Korea

“…Currently, trainee endoscopic skills are assessed based on the number of procedures performed and a qualifying examination [7]. Although these methods have produced excellent endoscopists, the assessment tools require improvement.…”

Efficacy and Patient Tolerability Profiles of Probiotic Solution with Bisacodyl Versus Conventional Cleansing Solution for Bowel Preparation: A Prospective, Randomized, Controlled Trial

“…In addition to patient co-morbidities and education levels for bowel preparation procedures, the patient tolerability profiles for bowel preparation agents are significantly associated with achieving adequate screening colonoscopy [ 13 , 14 , 16 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. To improve patient preferences for bowel cleansing agents, several bowel preparation methods have been developed, such as a single dose vs. a split dose of purgatives; conventional large volume vs. ultra-low dose of bowel preparation agents; sulfate-free polyethylene glycol (PEG) vs. sodium phosphate solution; low-volume PEG plus ascorbic acid vs. high-volume PEG; and conventional PEG with bisacodyl, candy, coffee, or orange juice [ 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ].…”