Successful applicants to the ASGE Endoscopy Unit Recognition Program submit a summary of a recently conducted quality improvement (QI) project as part of the application process. The QI project in the spotlight this month looked at increasing withdrawal time.
DEFINE
Gastroenterology published "AGA Clinical Practice Update on Strategies to Improve Quality of Screening and Surveillance Colonoscopy: Expert Review." Gastroenterology 2021;161;701-711. This article demonstrates the best practice is increased withdrawal times during colonoscopies ≥ 6 minutes with the aspiration target of ≥ 9 minutes.
Increasing colonoscopy withdrawal time has shown to improve adenoma detection rates, a key indicator in colorectal cancer screening. Implementing a protocol that encourages a longer withdrawal time has demonstrated an increase in adenoma detection rate.
To ensure our patients are receiving a high-quality colonoscopy, with the best results in detecting adenomas, our gastroenterologists have increased their withdrawal times to ≥ 9 minutes.
MEASURE
Our initial compliance assessment showed an average of 6.8 minutes for 2023. The goal was to increase colonoscopy withdrawal time to 9 minutes.
Our percentage showed a deficiency of 75.5% as our goal measure is ≥ 9-minute withdrawal time.
The study was conducted by analyzing GIQUIC and [endowriter] reports monthly for each GI physician.
ANALYZE
The data is obtained through GIQUIC and analyzed monthly. The results are then presented to and evaluated by the [institution]’s GI and GIQUIC Quality Sub committees on a quarterly basis.
CONTROL
A monthly scorecard was implemented to provide physicians with transparent feedback on their performance. Documentation was reviewed monthly. Our score improved from 6.8 to 8.5 minutes.
SUMMARY/OUTCOME
Our scores improved from 6.8 minutes to 8.5 minutes
1st quarter 7.5 minutes
2nd quarter 9.2 minutes
3rd quarter 8.9 minutes
4th quarter 9.0 minutes
Average of 8.5 minutes
Our Adenoma detect rate has shown a substantial increase, rising from 29.6% in 2022 to 43.7% in 2023, representing a 48% improvement. This achievement underscores the effectiveness of the strategic modifications that were implemented to colonoscopy withdrawal times.
We hope sharing this project summary will be useful to you and your practice. Learn more about gaining honoree status in the
ASGE Endoscopy Unit Recognition Program. EURP honoree units may use the ASGE Quality Star logo in promotion of their units, receive premium educational content via an exclusive e-newsletter
The Huddle, and enjoy a range of additional benefits. Questions should be directed to
eurp@asge.org.