TY - JOUR
T1 - Pre- and post-procedural quality indicators for colonoscopy
T2 - A nationwide survey
AU - Paggi, Silvia
AU - Amato, Arnaldo
AU - Anderloni, Andrea
AU - Annese, Vito
AU - Barresi, Luca
AU - Buda, Andrea
AU - Cesaro, Paola
AU - Di Giulio, Emilio
AU - Gullotti, Giuseppe
AU - Fabbri, Carlo
AU - Fiori, Giancarla
AU - Fuccio, Lorenzo
AU - Manno, Mauro
AU - Musso, Alessandro
AU - Rondonotti, Emanuele
AU - Trovato, Cristina
AU - Hassan, Cesare
AU - Repici, Alessandro
AU - Radaelli, Franco
PY - 2016/1/31
Y1 - 2016/1/31
N2 - Background: The provision of high-quality colonoscopy can be assessed by evaluating technical aspects of the procedure and, at individual center level, by comparing structural indicators and institutional policies for managing peri-procedural issues with guideline recommendations. Aim: To assess the colonoscopy quality (CQ) in Italy at center level. Methods: Gastroenterologists participating in a nationwide colonoscopy education initiative provided information on structural indicators of their centers and on institutional policies by answering 10 multiple-choice clinical scenarios. Practice variation across centers and compliance with guidelines were analyzed. Results: Data from 282 Italian centers were evaluated. Overall, a significant proportion of centers did not meet CQ standards as concerns endoscopy facilities and equipments (e.g., dedicated recovery room, dirty-to-clean path, reporting software). CQ assurance programs were implemented in only 25% of centers. Concerning peri-procedural issues, main discrepancies with guidelines were recorded in the underuse of split-dose preparation (routinely adopted by 18% of centers), the routine request of coagulation tests prior to colonoscopy (30%), the routine interruption of aspirin for polypectomy (18%), and the adoption of 3-year surveillance for low-risk adenoma (49%). Conclusions: Present survey shows a significant variation in the CQ of endoscopy centers in Italy on many items of colonoscopy practice that should be targeted for future interventions.
AB - Background: The provision of high-quality colonoscopy can be assessed by evaluating technical aspects of the procedure and, at individual center level, by comparing structural indicators and institutional policies for managing peri-procedural issues with guideline recommendations. Aim: To assess the colonoscopy quality (CQ) in Italy at center level. Methods: Gastroenterologists participating in a nationwide colonoscopy education initiative provided information on structural indicators of their centers and on institutional policies by answering 10 multiple-choice clinical scenarios. Practice variation across centers and compliance with guidelines were analyzed. Results: Data from 282 Italian centers were evaluated. Overall, a significant proportion of centers did not meet CQ standards as concerns endoscopy facilities and equipments (e.g., dedicated recovery room, dirty-to-clean path, reporting software). CQ assurance programs were implemented in only 25% of centers. Concerning peri-procedural issues, main discrepancies with guidelines were recorded in the underuse of split-dose preparation (routinely adopted by 18% of centers), the routine request of coagulation tests prior to colonoscopy (30%), the routine interruption of aspirin for polypectomy (18%), and the adoption of 3-year surveillance for low-risk adenoma (49%). Conclusions: Present survey shows a significant variation in the CQ of endoscopy centers in Italy on many items of colonoscopy practice that should be targeted for future interventions.
KW - Colonoscopy
KW - Practice guidelines
KW - Quality
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U2 - 10.1016/j.dld.2016.03.017
DO - 10.1016/j.dld.2016.03.017
M3 - Article
AN - SCOPUS:84963959534
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
ER -