Effect of quarterly meeting and email report of ADR, cecal intubation rate, and withdrawal time on personal and group quality measures in colonoscopy

Abstract

Introduction

Colonoscopy is the most utilized screening test for colorectal cancer (CRC). The adenoma detection rate (ADR), cecal intubation rate (CIR), and withdrawal time (WT) are established quality indicators (QIs) for colonoscopy. The aim was to measure the effect of individual and group QIs in colonoscopy by providing quarterly meetings and email feedback on ADR, CIR, and WT.

Material and methods

This is a prospective study in 2 steps. In the initial phase, we aimed to collect the QIs in colonoscopy from our division and in the second step, we aimed to assess the impact of a quarterly report. Pre-Intervention: Using electronic medical records (EMRs), an automated method for calculating the ADR was devised. ADRs from 6 months were obtained. Periodic Feedback: Endoscopists received quarterly feedback during staff meetings and emails for 9 months. Post-Intervention: QIs were recalculated for 8 months, and physicians did not receive reports.

Results

Over 23 months, 1,137 screening colonoscopies were conducted. Seven gastroenterologists participated, distributed into high (n = 6) and low (n = 1) detector groups. The mean patient age was 58.6 ± 9.2 years, with 659 (57.9%) females. Moderate sedation was used in 892 (78.4%) cases. QIs did not show significant improvement during the feedback or post-intervention periods compared with the pre-intervention period. Endoscopists initially categorized as «low detectors» exhibited the most substantial improvement, with the ADR increasing from 23.5% to 61.5% (P < .001).

Conclusion

Quarterly feedback and email reports did not significantly improve colonoscopy quality measures. Regarding the ADR, the intervention’s impact was most prominent in «low detectors».