It’s important to have standards for quality colonoscopy and to be sure that quality measures are included in doctors’ reports after each procedure.
In light of the recently published study showing colonoscopy impact on deaths from colorectal cancer, the American Gastroenterological Association (AGA) points out the value of documenting and reporting key indicators for a quality colonoscopy after every procedure.
In collaboration with the American Society for Gastrointestinal Endoscopy, the American College of Gastroenterology, and the American Medical Association, the AGA developed three standards to measure quality colonoscopy performance by physicians.
- An appropriate follow-up interval after a normal colonoscopy in average risk patients
- An appropriate schedule for surveillance of patients with a history of colon polyps
- Comprehensive colonoscopy documentation
Measure #3 calls for the following to documented, and reported for all colonoscopies:
- Pre-procedure patient risk assessment
- Depth of insertion of colonoscope and whether cecum was reached
- Quality of bowel cleansing prep
- Complete description of each polyp found including its size, location, number, and gross appearance
- Recommendations for followup
Robert Sandler, M.D., AGAF, president of the AGA Institute pointed out,
It’s of paramount importance that physicians perform a colonoscopy examination as effectively as possible. Gastroenterologists are aware of the need to slowly withdraw the colonoscope and to carefully examine the right colon for flat polyps. The most important variable in colonoscopy is the skill of the physician performing the test. Having a well trained, careful endoscopist who is aware of the newest ideas and techniques is a patient’s best protection against poor results.
The AGA Institute has information for patients to help them understand colonoscopy.
SOURCE: AGA eDigest, December 18, 2008.