As patients and the federal government demand more quality information from gastroenterological surgery centers, GI centers and their physicians are looking to establish nationwide quality benchmarks that everyone can confidently use.
In July, the GI Quality Improvement Consortium, known as the GIQuIC, began collecting 12 quality indicators for colonoscopy from ambulatory surgery centers, GI practices and other venues.
The GIQuIC includes the American College of Gastroenterology, the American Society for Gastrointestinal Endoscopy and other thought-leaders in the specialty. The initial benchmarking categories, tested in a two-year pilot program and determined by ACG-ASGE Joint Task Force for the Development of GI Endoscopy Quality Indicators, will be used for national benchmarking.
"The ultimate goal of the task force was to determine whether a valid and reliable comparative information measurement tool for consumers and payers could be constructed and used," says Barry Tanner, president and CEO of Physicians Endoscopy in Doylestown, Pa.
Here are the 12 quality indicators.
1. History & physical documentation
2. Informed consent documentation including potential complications
3. Adequacy of bowel prep. A bowel prep is adequate when the examiner can identify polyps that are 6 mm. in size or larger.
4. Written outpatient discharge instructions
5. Documentation of patient's ASA category. The ASA category measures patients' fitness for surgery in the ambulatory setting. There are four levels. Patients up to level three can be seen in the ASC.
6. Documentation of indications for the procedure
7. Cecal intubation rate for all colonoscopies and for screening or surveillance procedures
8. Adenoma detection rate. In a screening colonoscopy, the ASC reports how often the physician found an adenoma in patients age 50 years or older and how many were male and how many female.
9. Polyp morphology described. How exact is the description of the shape?
10. Polyp size described. How exact is the description of the size?
11. Withdrawal time from a cecum screening. How long did it take to withdraw the scope? Since, according to widely accepted theory, the best view is possible during withdrawal of the scope, a fairly slow withdrawal is desirable. Around 6-8 minutes is considered the proper amount of time.
12. Reporting adverse events during colonoscopy. Adverse events include perforation, bleeding, ED visit related to procedure, hospital admission related to procedure and a sedation-related event.
Learn more about the GIQuIC quality indicators.
Learn more about Physicians Endoscopy.
Read more about GI:
- 10 Most-Read Gastroenterology News Stories of 2010
- IU Gastroenterologist Says Colonoscopy Can Be a Viable Tool for CRC Prevention
- Four out of Five Providers Fail to Follow All CRC Screening Guidelines