title: Practice and documentation of performance of colonoscopy in a central Canadian health region.
abstract: OBJECTIVE
  To evaluate the reporting and performance of colonoscopy in a large urban centre.
  
  
  METHODS
  Colonoscopies performed between January and April 2008 in community hospitals and academic centres in the Winnipeg Regional Health Authority (Manitoba) were identified from hospital discharge databases and retrospective review of a random sample of identified charts. Information regarding reporting of colonoscopies (including bowel preparation, photodocumentation of cecum⁄ileum, size, site, characteristics and method of polyp removal), colonoscopy completion rates and follow-up recommendations was extracted. Colonoscopy completion rates were compared among different groups of physicians.
  
  
  RESULTS
  A total of 797 colonoscopies were evaluated. Several deficiencies in reporting were identified. For example, bowel preparation quality was reported in only 20%, the agent used for bowel preparation was recorded in 50%, photodocumentation of colonoscopy completion in 6% and polyp appearance (ie, pedunculated or not) in 34%, and polyp size in 66%. Although the overall colonoscopy completion rate was 92%, there was a significant difference among physicians with varying medical specialty training and volume of procedures performed. Recommendations for follow-up procedures (barium enema, computed tomography colonography or repeat colonoscopy) were recorded for a minority of individuals with reported poor bowel preparation or incomplete colonoscopy.
  
  
  CONCLUSIONS
  The present study found many deficiencies in reporting of colonoscopy in typical, city-wide clinical practices. Colonoscopy completion rates varied among different physician specialties. There is an urgent need to adopt standardized colonoscopy reporting systems in everyday practice and to provide feedback to physicians regarding deficiencies so they can be rectified.
authors.forename: Harminder
authors.initials: H
authors.lastname: Singh
authors.forename: Lisa
authors.initials: L
authors.lastname: Kaita
authors.forename: Gerry
authors.initials: G
authors.lastname: Taylor
authors.forename: Zoann
authors.initials: Z
authors.lastname: Nugent
authors.forename: Charles
authors.initials: C
authors.lastname: Bernstein
mesh_terms: D000046:Academic Medical Centers / Q000592:standards; D000368:Aged; D002400:Cathartics / Q000008:administration & dosage; D002983:Clinical Competence; D003111:Colonic Polyps / Q000473:pathology*; D003113:Colonoscopy / Q000009:adverse effects / Q000592:standards* / Q000706:statistics & numerical data*; D016292:Procedural Sedation; D004282:Documentation / Q000592:standards* / Q000706:statistics & numerical data*; D005260:Female; D005762:Gastroenterology / Q000592:standards; D058006:General Practice / Q000592:standards; D013502:General Surgery / Q000592:standards; D006786:Hospitals, Urban / Q000592:standards; D006801:Humans; D008297:Male; D008350:Manitoba; D008875:Middle Aged; D010781:Photography / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies
chemical_list: D002400:Cathartics
references.citation: Am J Gastroenterol. 2010 Dec;105(12):2588-96
references.pmid: 20877348
references.citation: Gastroenterology. 2012 Feb;142(2):194-6
references.pmid: 22178380
references.citation: Am J Gastroenterol. 2006 Apr;101(4):873-85
references.pmid: 16635231
references.citation: Gastroenterology. 2010 Oct;139(4):1128-37
references.pmid: 20600026
references.citation: J Clin Oncol. 2012 Jul 20;30(21):2664-9
references.pmid: 22689809
references.citation: N Engl J Med. 2013 Sep 19;369(12):1095-105
references.pmid: 24047059
references.citation: Ann Intern Med. 2011 Jan 4;154(1):22-30
references.pmid: 21200035
references.citation: Gastrointest Endosc. 2010 Jun;71(7):1253-9
references.pmid: 20598251
references.citation: Clin Gastroenterol Hepatol. 2014 Dec;12(12):1973-80
references.pmid: 24095973
references.citation: Gastroenterology. 2011 Jan;140(1):65-72
references.pmid: 20854818
references.citation: Can J Gastroenterol. 2007 Nov;21 Suppl D:5D-24D
references.pmid: 18026582
references.citation: Ann Intern Med. 2009 Jan 6;150(1):1-8
references.pmid: 19075198
references.citation: Gastrointest Endosc. 2013 Jun;77(6):925-31
references.pmid: 23472996
references.citation: Am J Gastroenterol. 2010 Mar;105(3):663-73; quiz 674
references.pmid: 19904239
references.citation: Am J Gastroenterol. 2008 May;103(5):1249-56
references.pmid: 18190650