Impact of a Citywide Benchmarking Intervention on Colonoscopy Quality Performance.
Benchmarking
/ standards
Clinical Competence
/ standards
Colonoscopy
/ standards
Colorectal Neoplasms
/ diagnosis
Early Detection of Cancer
/ standards
Female
Healthcare Disparities
/ standards
Humans
Male
Middle Aged
New York City
Practice Patterns, Physicians'
/ standards
Quality Improvement
/ standards
Quality Indicators, Health Care
/ standards
Registries
Colon cancer prevention
Colonoscopy quality
Colorectal cancer screening
Journal
Digestive diseases and sciences
ISSN: 1573-2568
Titre abrégé: Dig Dis Sci
Pays: United States
ID NLM: 7902782
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
27
10
2019
accepted:
09
01
2020
pubmed:
10
2
2020
medline:
30
12
2020
entrez:
10
2
2020
Statut:
ppublish
Résumé
There is marked variability in colonoscopy quality, limiting its effectiveness in colorectal cancer prevention. Multiple indicators have been established as markers for colonoscopy quality; however, there are conflicting data on the effects of quality reporting programs on endoscopist performance. In this study, we investigate the impact of a multicenter quarterly report card initiative on colonoscopy quality metric performance. Data were collected from 194 endoscopists at 10 participating sites throughout New York City using a Qualified Clinical Data Registry from January 2013 to December 2014. Adenoma detection rate (ADR), cecal intubation rate, withdrawal time, bowel preparation quality and appropriate interval recommendations were tracked. Report cards were distributed to each site on a quarterly basis and technical assistance was provided as needed. Performance trends were analyzed using the Cochran-Armitage trend and analysis of variance tests. 37,258 screening colonoscopies were performed during the study period. There was a positive performance trend for ADR over time from the first quarter of 2013 to the last quarter of 2014 (15.6-25.7%; p < 0.001). There were also increases in cecal intubation rates (78.2-92.6%; p < 0.001), bowel preparation adequacy rates (77.5-92.8%; p < 0.001), and adherence to appropriate screening intervals (28.0-55.0%; p < 0.001). There was no clinically significant change in mean withdrawal time. The implementation of a quarterly report card initiative resulted in statistically significant improvements in adenoma detection, cecal intubation, bowel preparation adequacy rates, and appropriate recommended screening intervals.
Identifiants
pubmed: 32036513
doi: 10.1007/s10620-020-06067-y
pii: 10.1007/s10620-020-06067-y
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
2534-2541Subventions
Organisme : CDC HHS
ID : IU58DP0000783
Pays : United States
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