Performance Measures
As a part of the Colorectal Health Advisory Board, a subcommittee for quality improvement has been established. Our committee has reviewed current American Society for Gastrointestinal Endoscopy (ASGE) standards, which state:
Studies have demonstrated increased detection of significant neoplastic lesions in colonoscopic examinations where the withdrawal time is 6 minutes or more. Mean withdrawal time should be > or equal to 6 minutes in colonoscopies with normal results performed in patients with intact colons and visualization of the cecum by notation of landmarks and photodocumentation of landmarks should be documented in every procedure.
Cecum Withdrawal Compliance
| Month | Dr. Parsons |
|---|---|
| April | 100% |
| May | 100% |
| June | 100% |
The inclusion of a retroflexed view of the rectum has become an essential element of colonoscopy by most colonoscopists. Although significant pathology is infrequently found only on retroflexion, the safety of the maneuver, coupled with the rapidity with which it can be performed, should encourage all endoscopists to include retroflexion in the rectum in order to ensure a complete colonoscopy, especially for evaluation of hematochezia.
The committee has decided to adapt these standards into our practice at NCH.
In order to demonstrate compliance with standards, physicians will need to:
- Inform the procedure room nurse when cecum has been intubated.
- Take a photo of cecum and label the photo for the procedure record. Print the photo to be included in the medical record.
- Document retroflexion in the procedure report.
Effective November 1, 2007, audits have been conducted to assess compliance with these standards. Beginning December 1, 2007, this time has been documented on the procedure record and automated reports will be generated on withdrawal time from cecum to be reviewed by the QI committee. The results of these reports will be published on this website quarterly.