Department of Gastroenterology, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium.
Department of Gastroenterology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
Acta Gastroenterol Belg. 2022 Apr-Jun;85(2):259-266. doi: 10.51821/85.2.9706.
Adenoma detection rate in patients aged 50 years or older (ADR50) is considered by the European Society of Gastrointestinal Endoscopy (ESGE) a key performance measures for lower gastrointestinal endoscopy. Technical and human resources constrain implementation of recording quality monitoring. The aim was to deploy an infrastructure for continuous monitoring of endoscopy quality indicators. And to evaluate its potential benefit on quality performance.
A company reporting system was adapted by adding a dedicated tab for quality monitoring, including: preparation, progression, number of resected polyps. Automated linkage with the pathology database resulted in continuous monitoring of inter alia: rate of adequate bowel preparation, cecal intubation rate and ADR50. Continuous monitoring was done for all nine endoscopists working at our center, with individual feedback after 4, 9 and 28 months.
A total of 1434 colonoscopies were performed during the first 9 months of monitoring, 682 during the first 4 months, 752 during the following 5 months. Five months after feedback a global increase in ADR50 of 4.6% (22.9% to 27.5%) (P<0.05) was observed, compared to the first 4 months. Thus meeting the benchmark (≥25%) recommended by ESGE. A durable effect of monitoring and feedback was observed after 28 months (ADR50: 29.4%).
An easy to use infrastructure for registration of quality monitoring in daily endoscopy practice, automatically linking the pathology database, facilitates continuous monitoring of endoscopy quality indicators. A global and durable ADR50 increase was observed after feedback, considered a quality improvement in performance of lower gastrointestinal endoscopy at our center.
欧洲胃肠道内镜学会（ESGE）认为，50 岁及以上患者的腺瘤检出率（ADR50）是下胃肠道内镜的关键绩效指标之一。技术和人力资源限制了记录质量监测的实施。目的是部署一个用于持续监测内镜质量指标的基础设施，并评估其对质量性能的潜在益处。
通过添加一个专门用于质量监测的标签，对公司报告系统进行了改编，其中包括：准备情况、进展情况、切除的息肉数量。与病理数据库的自动链接导致连续监测，包括：肠道准备充分率、盲肠插管率和 ADR50。对在我们中心工作的九位内镜医生进行了连续监测，在 4、9 和 28 个月后进行个人反馈。
在监测的前 9 个月内共进行了 1434 例结肠镜检查，前 4 个月进行了 682 例，接下来的 5 个月进行了 752 例。在反馈后的 5 个月内，ADR50 总体增加了 4.6%（从 22.9%增加到 27.5%）（P<0.05），与前 4 个月相比。因此，满足了 ESGE 推荐的基准（≥25%）。在 28 个月后观察到监测和反馈的持久效果（ADR50：29.4%）。
一种易于使用的基础设施，用于在日常内镜实践中注册质量监测，自动链接病理数据库，有助于连续监测内镜质量指标。在反馈后观察到全球和持久的 ADR50 增加，被认为是我们中心下胃肠道内镜性能的质量改进。
