Can colonoscopy at peripheral day hospitals meet internationally accepted quality and safety standards?

AIMS

To perform an independent review of the quality and safety of colonoscopy service at the Canterbury Charity Hospital (CCH).

METHODS

Demographic, endoscopy and histology data on all colonoscopies performed at CCH between 1 October 2016 and 31 September 2017 were collected. Quality indicators ascertained were caecal intubation rate, mean withdrawal time and adenoma detection rate (ADR). These were assessed using current recommendations by the Joint American College of Gastroenterology and American Society of Gastrointestinal Endoscopy task force.

RESULTS

Thirty-four patients, mean age 44 years (range 21-62), underwent colonoscopy. The most common indications were rectal bleeding and/or altered bowel habit (19 patients). Eight asymptomatic patients underwent colonoscopy because of a family history of CRC or a personal history of colorectal polyps; six of these were over 50 years old. Twelve patients had haemorrhoids and seven patients had adenomatous polyps. The caecal intubation rate was 97.1%. Among asymptomatic patients over 50 years undergoing colonoscopy, mean withdrawal time was 7.5 minutes (range 5-10) and ADR was 33.3%. No complications were recorded.

CONCLUSION

The colonoscopy service at CCH was safe and complied with the accepted quality indicators. Our data suggest that delivery of high-quality colonoscopy services might be possible in similar peripheral and day hospitals around New Zealand. Increasing colonoscopy services in such centres would reduce the excessive workload of larger public hospitals and reduce the level of unmet need for colonoscopy services.