Department of Gastroenterology & Hepatology, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
Department of Gastroenterology & Hepatology, Deventer Hospital, Deventer, the Netherlands.
Gastrointest Endosc. 2020 Jul;92(1):154-162.e1. doi: 10.1016/j.gie.2020.01.052. Epub 2020 Feb 11.
The importance of having quality assessment, assurance, and improvement tools in health care is increasingly recognized. However, the additional associated administration burden progressively interferes with the structural implementation and adoption of such tools, especially when it concerns high-volume procedures such as colonoscopies. The development of the Dutch Gastrointestinal Endoscopy Audit (DGEA), a registry with automated extraction of colonoscopy quality data, and its first results are described.
In close cooperation with commercial endoscopy reporting systems and a national histopathology database, healthcare professionals performing colonoscopies initiated a quality registry that extracts data from its core hospital resource or histology database without manual interference of the healthcare providers. Data extracted consisted of patient age, gender, indication of the colonoscopy, American Society of Anesthesiologists score, Boston Bowel Preparation Score, and cecal intubation; for the colonoscopy after a positive fecal immunochemical test in the colorectal cancer screening program, other data were polyp detection rate, which was available for all 48 hospitals or endoscopy centers, and adenoma detection rate, which was available for 26 hospitals or endoscopy centers.
Between January 1, 2016 and March 31, 2019, 48 hospitals or endoscopy centers voluntarily participated in the DGEA, and 275,017 unique patients with 313,511 colonoscopies were registered. Overall missing values were limited to <1%.
The results of this study demonstrate that it is feasible to deploy a quality registry collecting uniform data without additional administration burden for healthcare professionals.
越来越多的人认识到，医疗保健领域拥有质量评估、保证和改进工具的重要性。然而，额外的管理负担逐渐干扰了这些工具的结构实施和采用，特别是当涉及到结肠镜检查等高容量程序时。本文描述了荷兰胃肠内镜审核（DGEA）的发展，这是一个具有自动提取结肠镜质量数据功能的登记处，以及它的初步结果。
在与商业内镜报告系统和国家组织病理学数据库密切合作的基础上，进行结肠镜检查的医疗保健专业人员启动了一个质量登记处，该登记处从其核心医院资源或组织病理学数据库中提取数据，而无需医疗保健提供者的手动干预。提取的数据包括患者年龄、性别、结肠镜检查指征、美国麻醉医师协会评分、波士顿肠道准备评分和盲肠插管；对于结直肠癌筛查计划中粪便免疫化学检测阳性后的结肠镜检查，其他数据包括息肉检出率，所有 48 家医院或内镜中心都可获得该数据，腺瘤检出率，26 家医院或内镜中心可获得该数据。
2016 年 1 月 1 日至 2019 年 3 月 31 日，48 家医院或内镜中心自愿参与了 DGEA，共登记了 275017 名接受了 313511 次结肠镜检查的独特患者。总体缺失值限制在<1%。
本研究结果表明，部署一个收集统一数据的质量登记处而不会给医疗保健专业人员带来额外管理负担是可行的。
