1. Improving colonoscopy quality through individualised training programmes.
- Author
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Pedersen L, Bernstein I, Lindorff-Larsen K, Carlsen CG, and Torp-Pedersen C
- Subjects
- Colonic Polyps surgery, Colonoscopy standards, Denmark, Employee Performance Appraisal, Female, Gastroenterology standards, Humans, Male, Medical Staff, Hospital education, Middle Aged, Pilot Projects, Program Evaluation, Clinical Competence standards, Colonoscopy education, Education methods, Gastroenterology education, Quality Improvement
- Abstract
Introduction: In Denmark, quality-improvement initiatives aimed at providing a better colonoscopy service are few. The primary objective of this study was to improve colonoscopy quality at Aalborg University Hospital, Denmark, using structured training programmes. The secondary aim was to introduce a system for individual colonoscopist performance monitoring., Methods: We conducted a colonoscopy-quality pilot study covering two major quality performance indicators: caecum intubation rate (CIR) and polyp detection rate (PDR). The pilot study was followed by colonoscopy training programmes offering experienced colonoscopists colonoscopy skills upgrading, polypectomy and train-the-trainers courses taught by English experts. Junior doctors completed a 20-day module-based colonoscopy-training programme. A regional individual colonoscopy quality-reporting system was developed as a supplementary file within the electronic health records., Results: The CIR increased from 87.1% to 92.1% (p less-than 0.001) and the PDR from 33.7% to 41.7% (p less-than 0.001) in the course of the structured training programme. Multivariable analysis adjusting for patient sex, patient age and colonoscopy indication showed a significant increase in CIR (p less-than 0.001), but not in PDR (p = 0.19). The colonoscopy quality reporting system was introduced and now provides biannual feedback to all colonoscopists., Conclusions: Quality-improvement initiatives may lead to an improved CIR and possibly PDR. Nationwide training programmes and performance monitoring should be implemented to further improve and monitor colonoscopy quality., Funding: none., Trial Registration: not relevant., (Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.)
- Published
- 2020