113 COMPARING ADENOMA DETECTION RATE AND STANDARDIZED ADENOMA DETECTION RATIO AS QUALITY INDICATORS FOR SCREENING COLONOSCOPY AT AN URBAN SAFETY NET TERTIARY CARE HOSPITAL

BACKGROUND: Operator fatigue may negatively influence adenoma detection (AD) during screening colonoscopy.OBJECTIVE: To better characterize factors affecting AD, including the number of hours worked, and the number and type of procedures performed before an index screening colonoscopy.METHODS: A retrospective cohort study was conducted involving individuals undergoing a screening colonoscopy at a major tertiary care hospital in Montreal, Quebec. Individuals were identified using an endoscopic reporting database; AD was identified by an electronic chart review. A hierarchical logistic regression analysis was performed to determine the association between patient- and endoscopist-related variables and AD.RESULTS: A total of 430 consecutive colonoscopies performed by 10 gastroenterologists and two surgeons were included. Patient mean (± SD) age was 63.4±10.9 years, 56.3% were males, 27.7% had undergone a previous colonoscopy and the cecal intubation rate was 95.7%. The overall AD rate was 25.7%. Age was associated with AD (OR 1.06 [95% CI 1.03 to 1.08]), while female sex (OR 0.44 [95% CI 0.25 to 0.75]), an indication for average-risk screening (OR 0.47 [95% CI 0.27 to 0.80]) and an increase in the number of hours during which endoscopies were performed before the index colonoscopy (OR 0.87 [95% CI 0.76 to 0.99]) were associated with lower AD rates. On exploratory univariable analysis, a threshold of 3 h of endoscopy time performed before the index colonoscopy was associated with decreased AD.CONCLUSION: The number of hours devoted to endoscopies before the index colonoscopy was inversely associated with AD rate, with decreased performance possibly as early as within 3 h. This metric should be confirmed in future studies and considered when optimizing scheduling practices.

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Heart Stroke Plus: Analysis of quality indicators to create an improved pathway for patients following an acute coronary syndrome

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.098 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

L Perez De Isla ◽

JC Gomez Polo ◽

A Salinas Gallegos ◽

P Mahia Casado ◽

A Viana Tejedor ◽

...

Keyword(s):

Blood Pressure ◽

Acute Coronary Syndrome ◽

Quality Indicators ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Blood Analysis ◽

Lipid Lowering ◽

Care Hospital ◽

Post Discharge ◽

Coronary Syndrome

Abstract Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Sanofi Aventis S.A. Introduction Optimisation of the care of patients after an acute coronary syndrome (ACS) is a fundamental step to improve health outcomes and avoid consecutive cardiovascular events however data on how care is provided is often absent. Purpose Our objective was to analyse the main quality indicators in the post-ACS patient pathway so as to determine the actions which avoid future CDV events. Methods In a random sample of 100 patients between January 2018 and December 2019, we selected the indicators which most affect secondary prevention in patients post-ACS. All patients had been diagnosed with ACS within a tertiary-care hospital with a 24h interventional cardiology lab. The indicators were retrospectively analysed using the patients’ health record. Results The main results are presented in Table 1. Conclusions Based on this, we proposed an integrated protocol for all patients post-ACS which will begin in 2021 within this tertiary-care hospital. Within this protocol, the information contained in the discharge report will be improved and automatized as much as possible so as re-evaluate at a later date. Table 1: Demographics and results Title of the indicator Yes (%) No (%) Men 76 24 STEMI 40 60 NSTEMI 60 40 Dual antiplatelet therapy included in discharge report 100 0 High doses statins at discharge 98 2 BMI included in discharge report 0 100 LDL objective included in discharge report 14 86 HbA1c objective included in discharge report 13 87 Physical activity included in discharge report 15 85 Flu vaccination recomendations included in discharge report 0 100 Complete blood analysis completed 4-6 weeks after discharge 100 0 Blood pressure is measured on first post-discharge consultation 100 0 Blood pressure medication is changed on first post-discharge consultation 28 78 Patient arrives with measurement for HbA1c on first post-discharge consultation 78 22 Antidiabetic medication is modified on first post-discharge consultation 8 92 BMI is registered on first post-discharge consultation 0 100 Patients with LDL below 55mg/dl on first post-discharge consultation 29 71 Lipid-lowering medications is changed on first post-discharge consultation 29 71

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Tu2003 ESTABLISHING NEED FOR SERRATED POLYP DETECTION RATE AND ADVANCED ADENOMA DETECTION RATE BENCHMARKS AS QUALITY INDICATORS FOR SCREENING COLONOSCOPY

Gastroenterology ◽

10.1016/s0016-5085(20)33788-4 ◽

2020 ◽

Vol 158 (6) ◽

pp. S-1252

Author(s):

Shaman Dalal ◽

Aakash Desai ◽

Patrick Twohig ◽

Aun R. Shah ◽

Sara Kamionkowski ◽

...

Keyword(s):

Quality Indicators ◽

Detection Rate ◽

Adenoma Detection Rate ◽

Screening Colonoscopy ◽

Advanced Adenoma ◽

Polyp Detection ◽

Serrated Polyp ◽

Polyp Detection Rate ◽

Adenoma Detection

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Adenoma Detection Rate in Colonoscopy: Does the Participation of a Resident Matter?

The American Surgeon ◽

10.1177/000313481808400667 ◽

2018 ◽

Vol 84 (6) ◽

pp. 1064-1068

Author(s):

Jacquelyn S. Turner ◽

Desmond Henry ◽

Ayana Chase ◽

Dzifa Kpodzo ◽

Michael C. Flood ◽

...

Keyword(s):

Quality Indicators ◽

General Surgery ◽

Detection Rate ◽

Adenoma Detection Rate ◽

Screening Colonoscopy ◽

General Surgery Residency ◽

Adenoma Detection ◽

General Surgery Resident ◽

American Society ◽

Surgery Resident

Presently, endoscopic procedures are a requirement for training competency for completion of a general surgery residency. There are no studies to date that have assessed whether having a resident perform a colonoscopy impacts quality indicators such as adenoma detection rate (ADR). To retrospectively review ADR in adult patients, who undergo screening colonoscopy at a single institution with (ColFacR) and without (ColFac) the participation of a general surgery resident. A total of 792 patients were identified in the database screening colonoscopies between the ages of 45 and 80 from July 2013 to June 2015. Of those, 501 were reviewed after exclusion criteria. When comparing the ColFac group (n = 316) to the ColFacR group (n = 185), there were no differences between age, gender, body mass index, American Society of Anesthesiologists score, or quality of bowel preparation. The mean number of total polyps, hyperplastic polyps, and adenomatous polyps retrieved were similar between the two groups. There was no difference in the ADR for the ColFac cases and ColFacR cases (25.95% vs 27.03%, respectively, P = 0.834). ADR is similar in elective colonoscopies that were performed with or without a general surgery resident. The participation of a general surgery resident in routine colonoscopies should not impact reported quality indicators.

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