Tinmouth Jill, Patel Jigisha, Hilsden Robert J, Ivers Noah, Llovet Diego
ColonCancerCheck Program, Cancer Care Ontario, Canada; Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room HG40, Toronto, ON M4N 3M5, Canada.
Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room HG40, Toronto, ON M4N 3M5, Canada.
Best Pract Res Clin Gastroenterol. 2016 Jun;30(3):473-85. doi: 10.1016/j.bpg.2016.04.002. Epub 2016 Apr 16.
There is considerable variation in the quality of colonoscopy, attributable in part to endoscopist performance. Audit and feedback (A&F) provides health professionals with a summary of their performance over a period of time and is a common strategy used to improve provider performance. In this review, we discuss current understanding of the mechanism of A&F and describe specific features of effective A&F. To date, trials of A&F to improve colonoscopy performance report heterogeneous results, in part because colonoscopy is a complex procedural skill but also because the quality improvement interventions were sub-optimally implemented or inadequately evaluated. Nonetheless, evidence from a wide range of literature suggests that A&F has the potential to improve endoscopist performance. We discuss future directions for research in this area and provide guidance for providers or health system planners wishing to implement A&F to address quality of colonoscopy in their practice and/or jurisdiction.
结肠镜检查的质量存在很大差异，部分原因在于内镜医师的操作水平。审核与反馈（A&F）为医疗专业人员提供其在一段时间内的表现总结，是用于提高医疗服务提供者表现的常用策略。在本综述中，我们讨论了目前对审核与反馈机制的理解，并描述了有效审核与反馈的具体特征。迄今为止，关于审核与反馈以改善结肠镜检查表现的试验报告结果各异，部分原因是结肠镜检查是一项复杂的操作技能，还因为质量改进干预措施实施得不够理想或评估不充分。尽管如此，来自广泛文献的证据表明，审核与反馈有潜力改善内镜医师的表现。我们讨论了该领域未来的研究方向，并为希望在其实践和/或管辖范围内实施审核与反馈以解决结肠镜检查质量问题的医疗服务提供者或卫生系统规划者提供指导。
