Quality assurance and colonoscopy

Background and Study Aims: Little is known concerning the usefulness and fe asibility of quality assurance programs in gastrointestinal departments. Th e aim of this study was to identify the indicators of quality in colonoscop y, to check their use in clinical practice, and to identify their threshold values. Materials and Methods: A prospective study was performed in four endoscopic units, In the first phase, a questionnaire tvas used to identify the indic ators that were considered important and easy to record; in the second phas e, the selected items were prospectively recorded. Results: Data from 603 colonoscopies were evaluated. The selected indicator s were: rate of cecal intubation, rate of examinations with normal findings , rates of complications, appropriateness of indications, use of a washing machine for disinfection, duration of the disinfection procedure, rate of p rocedures repeated due to poor colon cleansing, rate of operative procedure s, length of waiting time, rate of procedures performed for follow-up of kn own disease, experience of the operator, and rate of procedures performed w ith the patient under conscious sedation. A striking difference emerged bet ween the technical standards at three centers, which were fairly good, and the standard at the fourth center, which was less satisfactory. The length of the waiting time was high in all centers, as well as the rate of examina tions conducted with an inappropriate indication. The rate of procedures pe rformed under conscious sedation varied widely between the centers, Conclusions: The study of the indicators of quality of colonoscopy is feasi ble and easy to perform in clinical practice, and can he useful for quality assurance programs.