Pre- and post-procedural quality indicators for colonoscopy: A nationwide survey

Silvia Paggi, Arnaldo Amato, Andrea Anderloni, Vito Annese, Luca Barresi, Andrea Buda, Paola Cesaro, Emilio Di Giulio, Giuseppe Gullotti, Carlo Fabbri, Giancarla Fiori, Lorenzo Fuccio, Mauro Manno, Alessandro Musso, Emanuele Rondonotti, Cristina Trovato, Cesare Hassan, Alessandro Repici, Franco Radaelli

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
JournalDigestive and Liver Disease
DOIs
Publication statusAccepted/In press - Jan 31 2016

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Keywords

  • Colonoscopy
  • Practice guidelines
  • Quality

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Paggi, S., Amato, A., Anderloni, A., Annese, V., Barresi, L., Buda, A., Cesaro, P., Di Giulio, E., Gullotti, G., Fabbri, C., Fiori, G., Fuccio, L., Manno, M., Musso, A., Rondonotti, E., Trovato, C., Hassan, C., Repici, A., & Radaelli, F. (Accepted/In press). Pre- and post-procedural quality indicators for colonoscopy: A nationwide survey. Digestive and Liver Disease. https://doi.org/10.1016/j.dld.2016.03.017