P7 Does individualised feedback improve colonoscopy key performance indicators?

Abstract

Introduction Colonoscopy is the gold standard examination of the bowel. Detection and removal of polyps leads to a reduced risk of subsequent colorectal cancer. Higher adenoma detection rate has been associated with a reduced post colonoscopy colorectal cancer rate. The BSG recommends a minimum performance standard, the key performance indicators (KPIs), which each independent endoscopist should achieve, to ensure quality. Monitoring of each endoscopists’ KPIs, and offering individual feedback to those falling below the standard, may lead to improvement. In this study we assessed the response in KPIs following such feedback. Methods KPIs between January 2017 and January 2018 were obtained from local ERS derived audit and endoscopists with KPIs below the minimum requirement were offered individual feedback by the clinical lead. Number of procedures, Polyp Detection Rate (PDR) and Caecal Intubation rate (CIR) were compared with data from colonoscopies performed between January 2019-January 2020 with data obtained from National Endoscopy Database. Opinion on individualised KPI reporting was measured across the department using Survey Monkey. Results Nine endoscopists (seven gastroenterologists, one surgeon, and one nurse endoscopist) were offered feedback as minimum quality standards were not met, all of whom took part in the feedback process. Six endoscopists’ CIR was below the minimum requirement. Three endoscopists’ CIR and PDR were below the minimum requirement. Two endoscopists performing less than 10 procedures per year, elected to cease performing colonoscopy. Four endoscopists with inadequate CIR improved following feedback. 1 endoscopist with insufficient PDR improved with feedback. 11 endoscopists responded to the survey. 82% reported checking their KPI at least annually, with the majority (45%) feeling that this should be reported quarterly. A formal individualised KPI report was felt to be useful by 64% of respondees. Conclusions Providing individualised feedback did help individuals’ KPIs in this cohort. We have demonstrated that using the NED data KPIs can be monitored with ease. A larger study involving multiple sites would give greater power to whether this could lead to a significant improvement in outcomes. Majority of endoscopists feel that an individualised KPI report will be helpful.