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UK Key Performance Indicators and Quality Assurance Standards for Colonoscopy

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Rees CJ, Thomas-Gibson S, Rutter MD, Baragwanath P, Pullan R, Feeney M, Haslam N.

Colonoscopy is the ‘gold standard’ investigation for assessment of the large bowel allowing diagnosis, biopsying, and therapy to be undertaken. Colonoscopy detects and prevents colorectal cancer, and is important tin the diagnosis and treatment of non-neoplastic conditions. Colonoscopy can lead to rare but serious complications and poor quality colonoscopy is associated with increased rates of interval cancers. The quality of UK colonoscopy has improved over recent years but unacceptable variation in practice still exists. Additionally the demand for colonoscopy is increasing.

In 2013 The Joint Advisory Group on GI Endoscopy, the British Society of Gastroenterology and the Association of Coloproctology commissioned a group to review existing and define new quality measures and key performance indicators for colonoscopy. For each standard a review of existing literature and evidence was undertaken. Where evidence exists it has been used to frame the standards. Where no clear evidence exists then existing standards and expert opinion have been used to arrive at agreed standards.

This document establishes clear minimal standards for KPI and QA measures. Where practice falls below these levels then interventions are required to raise the performance of those colonoscopists. Where the authors believed that higher standards would be ideal an aspirational target has been set. The authors believe that this is the level that all colonoscopists should be aiming for to provide the highest quality of practice.