Editorial
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World J Gastrointest Endosc. Oct 16, 2013; 5(10): 468-475
Published online Oct 16, 2013. doi: 10.4253/wjge.v5.i10.468
How we can measure quality in colonoscopy?
Leonidas A Bourikas, Zacharias P Tsiamoulos, Adam Haycock, Siwan Thomas-Gibson, Brian P Saunders
Leonidas A Bourikas, Zacharias P Tsiamoulos, Adam Haycock, Siwan Thomas-Gibson, Brian P Saunders, Wolfson Unit for Endoscopy, St Mark’s Hospital and Academic Institute, Imperial College, London HA1 3UJ, United Kingdom
Author contributions: Bourikas LA and Tsiamoulos ZP contributed equally to the production of this work; Bourikas LA, Tsiamoulos ZP and Saunders BP contributed to conception and design; Bourikas LA, Tsiamoulos ZP, Haycock A and Thomas-Gibson S contributed to collecting data and literature review and drafting the manuscript; Saunders BP contributed to critical revision of the article for important intellectual content, final approval of the article.
Correspondence to: Brian P Saunders, Consultant Gastroenterologist and Adjunct Professor in Endoscopy, Wolfson Unit for Endoscopy, St Mark’s Hospital and Academic Institute, Imperial College, London HA1 3UJ, United Kingdom. b.saunders@imperial.ac.uk
Telephone: +44-208-2354225 Fax: +44-208-84233588
Received: March 28, 2013
Revised: July 10, 2013
Accepted: August 16, 2013
Published online: October 16, 2013
Processing time: 201 Days and 5.9 Hours
Abstract

Measuring quality is a current need of medical services either to assess their cost-effectiveness or to identify discrepancies requiring refinement. With the advent of bowel cancer screening and increasing patient awareness of bowel symptoms, there has been an unprecedented increase in demand for colonoscopy. Consequently, there is an expanding open-discussion on missed rates of cancer or precancerous polyps during diagnostic/screening colonoscopy and on the rate of adverse events related to therapeutic colonoscopy. Delivering a quality colonoscopy service is therefore a healthcare priority. Colonoscopy is a multi-step process and therefore assessment of all aspects of the procedure must be addressed. Quality in colonoscopy refers to a combination of many patient-centered technical and non-technical skills and knowledge aiming to patient’s safety and satisfaction through a continuous effort for improvement. The benefits of this endless process are hiding behind small details which can eventually make the difference in colonoscopy. Identifying specific quality metrics help to define and shape an optimal service and forms a secure basis of improvement. Τhis paper does not aim to give technical details on how to perform colonoscopy but to summarize what to measure and when, in accordance with the current identified quality indicators and standards for colonoscopy.

Keywords: Colonoscopy; Quality assurance; Metrics; Standards; Outcome

Core tip: With the advent of bowel cancer screening and increasing patient awareness of bowel symptoms, there has been an unprecedented increase in demand for colonoscopy. Delivering a quality colonoscopy service is therefore a healthcare priority. Colonoscopy is a multi-step process and therefore assessment of all aspects of the procedure must be addressed. Quality in colonoscopy refers to a combination of many patient-centered technical and non-technical skills. Identifying specific quality metrics help to define and shape an optimal service.