Variation among endoscopy units in the achievement of the standards of colonoscopic performance indicators.
OBJECTIVE
To assess the achievement of quality standards of colonoscopy at six endoscopy units.


METHODS
Three indicators were used to assess the quality of 1056 colonoscopies performed at six hospitals: cecal intubation; adequate colon cleansing; and removal and recovery of all detected polyps. Analyses were performed on the total number of colonoscopies and on colonoscopies in which polyps were actually detected. The accomplishment of each indicator and a global compound index of all three indicators, named the Problem Rate, were analyzed. Results from each endoscopy unit were compared to previously established standards.


RESULTS
Adequate colon cleansing was the most frequent problem for quality in all centers; adequate colon preparation was 67% (range 50 to 84%). The cecum was reached in 84% of all colonoscopies (range 76 to 90%). 75% of all patients (range 28. 79%) had all polyps excised and recovered. All centers had rates below standard for one or several indicators (p<0.01, all cases). Two of the participant hospitals had an overall problem rate above the estimated standard (p<0.01).


CONCLUSIONS
There is a significant variation in the achievement of quality standards of colonoscopy between endoscopy units. Colon cleansing is the most frequent quality problem for colonoscopy.
Sánchez del Río
Antonio
A
Group of Hospitals Hospiten, Tenerife, Spain. alsanchezrg@yahoo.es
Campo
Rafel
R
Llach
Josep
J
Pons
Vicente
V
Mreish
Ghassan
G
Panadés
Agustí
A
Parra
Adolfo
A
Nicolás
D
D
Quintero
E
E
Nieto
M
M
Seoane
A
A
Torra
S
S
Pons
V
V
Argüello
L
L
Sala
T
T
Pertejo
V
V
Campo
R
R
Brullett
E
E
Junquera
F
F
Puig-Divi
V
V
Calvet
X
X
Montserrat
A
A
D000328:Adult; D000368:Aged; D003111:Colonic Polyps / Q000601:surgery; D003113:Colonoscopy / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011785:Quality Assurance, Health Care