Performance measures in inflammatory bowel disease surveillance colonoscopy: Implementing changes to practice improves performance

Research output: Contribution to journalArticlepeer-review

Standard

Performance measures in inflammatory bowel disease surveillance colonoscopy : Implementing changes to practice improves performance. / Smith, Samuel; Cannatelli, Rosanna; Bazarova, Alina; Sharma, Neel; McCulloch, Adam; Mak , Jason; Shivaji, Uday; Iqbal, Tariq; Kane, Kate; Ghosh, Subrata; Cooney, Rachel; Iacucci, Marietta.

In: Digestive Endoscopy, 03.09.2019.

Research output: Contribution to journalArticlepeer-review

Harvard

APA

Vancouver

Author

Bibtex

@article{7cc173b08ee34973833250a2ffc791b7,
title = "Performance measures in inflammatory bowel disease surveillance colonoscopy: Implementing changes to practice improves performance",
abstract = "Background and Aim: Dye-based chromoendoscopy (DCE) with targeted biopsies is recommended for inflammatory bowel disease (IBD) surveillance. However, DCE has not yet been widely adopted into clinical practice. We evaluated quality indicators in IBD surveillance following introduction of structured changes in service delivery. Methods: In August 2016, we introduced a number of changes to IBD surveillance practice in our endoscopy unit. These included training using interactive videos/images in a structured module, DCE as standard by using a foot-pedal operated pump jet, allocation of 45-minute procedure timeslots, targeted biopsies (except in high-risk patients), scoring of endoscopic disease activity, and lesion detection/morphology characterization. All IBD surveillance colonoscopies were allocated to a small team of four DCE-trained endoscopists. We compared quality measures for surveillance procedures carried out pre- and post-August 2016. The two groups were compared using chi-squared statistics. Results: A total of 598 IBD surveillance procedures (277 pre-August 2016 and 321 post-August 2016) were done and included in the study. Use of DCE increased (54.2% vs 76.0% P < 0.0005) whereas random biopsy surveillance decreased (12.3% vs 3.1% P < 0.0005). Use of Paris classification (26.1% vs 57.0% P < 0.0005) and Kudo pit pattern increased (21.7% vs 59.0% P < 0.0005). There was also an increase in lesion detection rate (24.9% vs 33.1% P < 0.05). Conclusions: Implementation of extensive changes in practice of surveillance colonoscopy resulted in significant improvement in quality indicators within a short period of time. Training, education and audit may continue to facilitate the adoption of DCE and further improve quality of performance in IBD surveillance.",
keywords = "Surveillance colonoscopy, Dye Chromoendoscopy, Key performance quality indicators, Colonic lesions detection and characterisation",
author = "Samuel Smith and Rosanna Cannatelli and Alina Bazarova and Neel Sharma and Adam McCulloch and Jason Mak and Uday Shivaji and Tariq Iqbal and Kate Kane and Subrata Ghosh and Rachel Cooney and Marietta Iacucci",
year = "2019",
month = sep,
day = "3",
doi = "10.1111/den.13521",
language = "English",
journal = "Digestive Endoscopy",
issn = "0915-5635",
publisher = "Wiley-Blackwell",

}

RIS

TY - JOUR

T1 - Performance measures in inflammatory bowel disease surveillance colonoscopy

T2 - Implementing changes to practice improves performance

AU - Smith, Samuel

AU - Cannatelli, Rosanna

AU - Bazarova, Alina

AU - Sharma, Neel

AU - McCulloch, Adam

AU - Mak , Jason

AU - Shivaji, Uday

AU - Iqbal, Tariq

AU - Kane, Kate

AU - Ghosh, Subrata

AU - Cooney, Rachel

AU - Iacucci, Marietta

PY - 2019/9/3

Y1 - 2019/9/3

N2 - Background and Aim: Dye-based chromoendoscopy (DCE) with targeted biopsies is recommended for inflammatory bowel disease (IBD) surveillance. However, DCE has not yet been widely adopted into clinical practice. We evaluated quality indicators in IBD surveillance following introduction of structured changes in service delivery. Methods: In August 2016, we introduced a number of changes to IBD surveillance practice in our endoscopy unit. These included training using interactive videos/images in a structured module, DCE as standard by using a foot-pedal operated pump jet, allocation of 45-minute procedure timeslots, targeted biopsies (except in high-risk patients), scoring of endoscopic disease activity, and lesion detection/morphology characterization. All IBD surveillance colonoscopies were allocated to a small team of four DCE-trained endoscopists. We compared quality measures for surveillance procedures carried out pre- and post-August 2016. The two groups were compared using chi-squared statistics. Results: A total of 598 IBD surveillance procedures (277 pre-August 2016 and 321 post-August 2016) were done and included in the study. Use of DCE increased (54.2% vs 76.0% P < 0.0005) whereas random biopsy surveillance decreased (12.3% vs 3.1% P < 0.0005). Use of Paris classification (26.1% vs 57.0% P < 0.0005) and Kudo pit pattern increased (21.7% vs 59.0% P < 0.0005). There was also an increase in lesion detection rate (24.9% vs 33.1% P < 0.05). Conclusions: Implementation of extensive changes in practice of surveillance colonoscopy resulted in significant improvement in quality indicators within a short period of time. Training, education and audit may continue to facilitate the adoption of DCE and further improve quality of performance in IBD surveillance.

AB - Background and Aim: Dye-based chromoendoscopy (DCE) with targeted biopsies is recommended for inflammatory bowel disease (IBD) surveillance. However, DCE has not yet been widely adopted into clinical practice. We evaluated quality indicators in IBD surveillance following introduction of structured changes in service delivery. Methods: In August 2016, we introduced a number of changes to IBD surveillance practice in our endoscopy unit. These included training using interactive videos/images in a structured module, DCE as standard by using a foot-pedal operated pump jet, allocation of 45-minute procedure timeslots, targeted biopsies (except in high-risk patients), scoring of endoscopic disease activity, and lesion detection/morphology characterization. All IBD surveillance colonoscopies were allocated to a small team of four DCE-trained endoscopists. We compared quality measures for surveillance procedures carried out pre- and post-August 2016. The two groups were compared using chi-squared statistics. Results: A total of 598 IBD surveillance procedures (277 pre-August 2016 and 321 post-August 2016) were done and included in the study. Use of DCE increased (54.2% vs 76.0% P < 0.0005) whereas random biopsy surveillance decreased (12.3% vs 3.1% P < 0.0005). Use of Paris classification (26.1% vs 57.0% P < 0.0005) and Kudo pit pattern increased (21.7% vs 59.0% P < 0.0005). There was also an increase in lesion detection rate (24.9% vs 33.1% P < 0.05). Conclusions: Implementation of extensive changes in practice of surveillance colonoscopy resulted in significant improvement in quality indicators within a short period of time. Training, education and audit may continue to facilitate the adoption of DCE and further improve quality of performance in IBD surveillance.

KW - Surveillance colonoscopy

KW - Dye Chromoendoscopy

KW - Key performance quality indicators

KW - Colonic lesions detection and characterisation

UR - http://www.scopus.com/inward/record.url?scp=85074763526&partnerID=8YFLogxK

U2 - 10.1111/den.13521

DO - 10.1111/den.13521

M3 - Article

JO - Digestive Endoscopy

JF - Digestive Endoscopy

SN - 0915-5635

ER -