Abstract
Quality in healthcare delivery is becoming more important. Due to the volume and cost expended on colonoscopy, it is a major focus area to reduce waste and inefficiencies. High-quality colonoscopy has been shown to reduce death from colorectal cancers. The primary measure for quality in colonoscopy is currently the adenoma detection rate. There is great variation among endoscopists with respect to quality. Endoscopists should know their personal quality metrics and participate in a cycle of continuous quality improvement to improve them. Physician reimbursement will be increasingly tied to quality measures.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Abbreviations
- ABCRS:
-
American Board of Colon and Rectal Surgery
- ABS:
-
American Board of Surgery
- ACG:
-
American College of Gastroenterology
- ADR:
-
Adenoma detection rate
- AGA:
-
American Gastroenterological Association
- APC:
-
Adenomas per colonoscopy
- ASGE:
-
American Society for Gastrointestinal Endoscopy
- CE:
-
Chromoendoscopy
- CQI:
-
Continuous quality improvement
- CRC:
-
Colorectal cancer
- EHR:
-
Electronic health record
- FES:
-
Fundamentals of Endoscopic Surgery
- MNA:
-
Mean number of adenomas
- NBI:
-
Narrow band imaging
- PDR:
-
Polyp detection rate
- PDSA:
-
Plan-Do-Study-Act
- PQRS:
-
Physician Quality Reporting System
- QCDR:
-
Qualified Clinical Data Registries
- RCA:
-
Root cause analysis
- SSA:
-
Sessile serrated adenoma
- VCE:
-
Virtual chromoendoscopy
References
Rosenthal E. Colonoscopies explain why U.S. leads the world in health expenditures. The New York Times [Internet]. 1 Jun 2013 [cited 25 Jan 2016]. http://www.nytimes.com/2013/06/02/health/colonoscopies-explain-why-us-leads-the-world-in-health-expenditures.html
Rex DK, Bond JH, Winawer S, Levin TR, Burt RW, Johnson DA, et al. Quality in the technical performance of colonoscopy and the continuous quality improvement process for colonoscopy: recommendations of the U.S. Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol. 2002;97(6):1296–308.
Rex DK, Petrini JL, Baron TH, Chak A, Cohen J, Deal SE, et al. Quality indicators for colonoscopy. Gastrointest Endosc. 2006;63(4 Suppl):S16–28.
Rex DK, Schoenfeld PS, Cohen J, Pike IM, Adler DG, Fennerty MB, et al. Quality indicators for colonoscopy. Gastrointest Endosc. 2015;81(1):31–53.
Shergill AK, Lightdale JR, Bruining DH, Acosta RD, Chandrasekhara V, Chathadi KV, et al. The role of endoscopy in inflammatory bowel disease. Gastrointest Endosc. 2015;81(5):1101–21.e13.
Simmons DT, Harewood GC, Baron TH, Petersen BT, Wang KK, Boyd-Enders F, et al. Impact of endoscopist withdrawal speed on polyp yield: implications for optimal colonoscopy withdrawal time. Aliment Pharmacol Ther. 2006;24(6):965–71.
Sawhney MS, Cury MS, Neeman N, Ngo LH, Lewis JM, Chuttani R, et al. Effect of institution-wide policy of colonoscopy withdrawal time ≥7 min on polyp detection. Gastroenterology. 2008;135(6):1892–8.
Corley DA, Jensen CD, Marks AR, Zhao WK, Lee JK, Doubeni CA, et al. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med. 2014;370(14):1298–306.
Denis B, Sauleau EA, Gendre I, Exbrayat C, Piette C, Dancourt V, et al. The mean number of adenomas per procedure should become the gold standard to measure the neoplasia yield of colonoscopy: a population-based cohort study. Dig Liver Dis. 2014;46(2):176–81.
Lieberman D, Nadel M, Smith RA, Atkin W, Duggirala SB, Fletcher R, et al. Standardized colonoscopy reporting and data system: report of the Quality Assurance Task Group of the National Colorectal Cancer Roundtable. Gastrointest Endosc. 2007;65(6):757–66.
Corley DA, Jensen CD, Marks AR. Can we improve adenoma detection rates? A systematic review of intervention studies. Gastrointest Endosc. 2011;74(3):656–65.
Subramanian V, Mannath J, Hawkey C, Ragunath K. High definition colonoscopy vs. standard video endoscopy for the detection of colonic polyps: a meta-analysis. Endoscopy. 2011;43(6):499–505.
Kamiński MF, Hassan C, Bisschops R, Pohl J, Pellisé M, Dekker E, et al. Advanced imaging for detection and differentiation of colorectal neoplasia: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2014;46(5):435–49.
Dinesen L, Chua TJ, Kaffes AJ. Meta-analysis of narrow-band imaging versus conventional colonoscopy for adenoma detection. Gastrointest Endosc. 2012;75(3):604–11.
Gralnek IM, Siersema PD, Halpern Z, Segol O, Melhem A, Suissa A, et al. Standard forward-viewing colonoscopy versus full-spectrum endoscopy: an international, multicentre, randomised, tandem colonoscopy trial. Lancet Oncol. 2014;15(3):353–60.
Decker MR, Dodgion CM, Kwok AC, Hu Y-Y, Havlena JA, Jiang W, et al. Specialization and the current practices of general surgeons. J Am Coll Surg. 2014;218(1):8–15.
Baxter NN, Warren JL, Barrett MJ, Stukel TA, Doria-Rose VP. Association between colonoscopy and colorectal cancer mortality in a US cohort according to site of cancer and colonoscopist specialty. J Clin Oncol. 2012;30(21):2664–9.
Mehran A, Jaffe P, Efron J, Vernava A, Liberman MA. Colonoscopy: why are general surgeons being excluded? Surg Endosc. 2003;17(12):1971–3.
The SAGES Colonoscopy Outcomes Study Group, Wexner SD, Garbus JE, Singh JJ. A prospective analysis of 13,580 colonoscopies: reevaluation of credentialing guidelines. Surg Endosc. 2001;15(3):251–61.
Charbel JM, Bastawrous AL, Froese D, Hawkins M, Kratz R, Menon R, et al. Colon and rectal surgeons: raising the endoscopy bar. J Am Coll Surg. 2015;221(4):e57.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this chapter
Cite this chapter
Philp, M.M. (2017). Detection: (CQI) Quality Measures and Tools for Improvement. In: Lee, S., Ross, H., Rivadeneira, D., Steele, S., Feingold, D. (eds) Advanced Colonoscopy and Endoluminal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-48370-2_13
Download citation
DOI: https://doi.org/10.1007/978-3-319-48370-2_13
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-48368-9
Online ISBN: 978-3-319-48370-2
eBook Packages: MedicineMedicine (R0)