TITLE

IMPROVING COLONOSCOPY COMPLETION RATES: THE IMPACT OF AUDIT

AUTHOR(S)
Bassi, A.; O'Toole, P.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA6
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Introduction: The BSG National Colonoscopy Audit reported that caecal intubation rates in the UK fall far short of the recommended 90%. Addressing this requires both national and local initiatives. The audit process is one tool for producing local service improvement. We report our experience of colonoscopy audit in a large teaching hospital. Methods: All colonoscopy reports produced between 1 February and 31 July 2000 were reviewed retrospectively. Comp etion rates and main reasons for failure were recorded for each operator. Procedures were regarded as complete if the ileum was entered or the ileocaecal valve identified, or it:scope advancement was prevented by stricture, tumour, or severe colitis. Based on these findings, several changes were implemented. The audit was then repeated using an identical method, for the same six month period in 2001. Results: During the first six month period 676 colonoscopies were performed. Overall completion rate was 75%. This was influenced by the poor performance of a small number of endoscopists. The commonest reason for failure was poor bowel preparation (35%). Following this, new bowel preparation guidelines were introduced, three endoscopists were retrained and the principal trainer attended the "Training the Trainers" course. During the second audit period there were 729 colonoscopies. Overall completion rate had improved to 89%, with improvement across all subgroups (Table). No perforations occurred in either audit period. Discussion: We acknowledge the obvious limitations of using selfreported caecal intubation rates, but believe this study confirms the value of audit os a tool for improving colonoscopy.
ACCESSION #
9747285

 

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