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

S. Paggi, Arnaldo Amato, Andrea Anderloni, V. Annese, Luca Sebastiano Barresi, Andrea Buda, Paola Cesaro, Emilio Di Giulio, G. Gullotti, C. Fabbri, Giancarla Fiori, Lorenzo Fuccio, Mauro Manno, Alessandro Musso, Emanuele Rondonotti, Cristina Maria Trovato, Cesare Hassan, Alessandro Repici, F. 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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Colonoscopy
Organizational Policy
Guidelines
Italy
Endoscopy
Recovery Room
Surveys and Questionnaires
Adenoma
Aspirin
Software
Education
Equipment and Supplies

Keywords

  • Colonoscopy
  • Practice guidelines
  • Quality

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Pre- and post-procedural quality indicators for colonoscopy : A nationwide survey. / Paggi, S.; Amato, Arnaldo; Anderloni, Andrea; Annese, V.; Barresi, Luca Sebastiano; Buda, Andrea; Cesaro, Paola; Di Giulio, Emilio; Gullotti, G.; Fabbri, C.; Fiori, Giancarla; Fuccio, Lorenzo; Manno, Mauro; Musso, Alessandro; Rondonotti, Emanuele; Trovato, Cristina Maria; Hassan, Cesare; Repici, Alessandro; Radaelli, F.

In: Digestive and Liver Disease, 31.01.2016.

Research output: Contribution to journalArticle

Paggi, S, Amato, A, Anderloni, A, Annese, V, Barresi, LS, Buda, A, Cesaro, P, Di Giulio, E, Gullotti, G, Fabbri, C, Fiori, G, Fuccio, L, Manno, M, Musso, A, Rondonotti, E, Trovato, CM, Hassan, C, Repici, A & Radaelli, F 2016, '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
Paggi, S. ; Amato, Arnaldo ; Anderloni, Andrea ; Annese, V. ; Barresi, Luca Sebastiano ; Buda, Andrea ; Cesaro, Paola ; Di Giulio, Emilio ; Gullotti, G. ; Fabbri, C. ; Fiori, Giancarla ; Fuccio, Lorenzo ; Manno, Mauro ; Musso, Alessandro ; Rondonotti, Emanuele ; Trovato, Cristina Maria ; Hassan, Cesare ; Repici, Alessandro ; Radaelli, F. / Pre- and post-procedural quality indicators for colonoscopy : A nationwide survey. In: Digestive and Liver Disease. 2016.
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AU - Paggi, S.

AU - Amato, Arnaldo

AU - Anderloni, Andrea

AU - Annese, V.

AU - Barresi, Luca Sebastiano

AU - Buda, Andrea

AU - Cesaro, Paola

AU - Di Giulio, Emilio

AU - Gullotti, G.

AU - Fabbri, C.

AU - Fiori, Giancarla

AU - Fuccio, Lorenzo

AU - Manno, Mauro

AU - Musso, Alessandro

AU - Rondonotti, Emanuele

AU - Trovato, Cristina Maria

AU - Hassan, Cesare

AU - Repici, Alessandro

AU - Radaelli, F.

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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.

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