Key performance measures for colonoscopy in the Polish Colonoscopy Screening Program

Marek Bugajski; Maciej Rupinski; Paulina Wieszczy; Małgorzata Pisera; Jaroslaw Regula; Michal F. Kaminski

doi:10.1055/a-0956-1889

Endoscopy, Table of Contents

Endoscopy 2019; 51(09): 858-865
DOI: 10.1055/a-0956-1889

Original article

Key performance measures for colonoscopy in the Polish Colonoscopy Screening Program

Marek Bugajski‡^*

¹Department of Gastroenterological Oncology, The Oncology Center, Maria Curie Institute, Warsaw, Poland

²Department of Gastroenterology, Hepatology and Clinical Oncology, Medical Center for Postgraduate Education, Warsaw, Poland

,

Maciej Rupinski‡^*

¹Department of Gastroenterological Oncology, The Oncology Center, Maria Curie Institute, Warsaw, Poland

²Department of Gastroenterology, Hepatology and Clinical Oncology, Medical Center for Postgraduate Education, Warsaw, Poland

,

Paulina Wieszczy

²Department of Gastroenterology, Hepatology and Clinical Oncology, Medical Center for Postgraduate Education, Warsaw, Poland

³Department of Cancer Prevention, The Oncology Center, Maria Curie Institute, Warsaw, Poland

,

Małgorzata Pisera

³Department of Cancer Prevention, The Oncology Center, Maria Curie Institute, Warsaw, Poland

,

Jaroslaw Regula

¹Department of Gastroenterological Oncology, The Oncology Center, Maria Curie Institute, Warsaw, Poland

²Department of Gastroenterology, Hepatology and Clinical Oncology, Medical Center for Postgraduate Education, Warsaw, Poland

,

Michal F. Kaminski

¹Department of Gastroenterological Oncology, The Oncology Center, Maria Curie Institute, Warsaw, Poland

⁴Department of Health Management and Health Economics, University of Oslo, Oslo, Norway

› Author Affiliations

Abstract

Background The European Society of Gastrointestinal Endoscopy (ESGE) has published guidelines on key performance measures for colonoscopy. We analyzed whether those standards were met in the Polish Colonoscopy Screening Program (PCSP) and whether the monitoring was feasible.

Methods We analyzed database records for 43 277 PCSP participants (25 PCSP centers) for the years 2014 – 2015. We used the guideline definitions to calculate values for all key performance measures and compared these with the proposed standards at individual, center, and program level. All data were acquired from the PCSP database, apart from complication data which was assessed from external registries.

Results At the program level, four of five minimum standards and one of two target standards (no set minimum standard) were met. Adequate bowel preparation rate was 91.3 % for the whole program (range among individual centers 79.2 % – 99.2 %). Cecal intubation rate was 97.4 % (93.4 % – 99.4 %). Adenoma detection rate was 29.8 % (19.1 % – 39.1 %). An appropriate polypectomy technique was applied in 62.7 % of cases (0.4 % – 97.8 %). Regarding complications, 7-day hospitalization rate after screening colonoscopy was 0.3 % (n = 127), and 30-day all-cause mortality was 0.02 % (n = 9). Patient feedback was assessed in 66.2 % of colonoscopies (7.6 % – 81.8 %). Appropriate post-polypectomy surveillance was proposed in 95.4 % of cases (range 84.9 % – -99.7 %). It was easy to monitor 6 of 7 key performance measures within the PCSP database, but monitoring complications required the additional effort of data extraction from external registries.

Conclusions The PCSP meets most proposed minimum standards at program level. Some centers need additional interventions to meet the complete set of quality standards. Use of ESGE performance measures for monitoring colonoscopy is generally feasible in the setting of the colonoscopy screening program.

Full Text

References

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