[Systematic quality control programme for colonoscopy in an endoscopy centre in Norway]

Colonoscopy is regarded as the gold standard for diagnosis of colorectal disease, and increasingly considered a primary screening approach for colorectal cancer. The quality of the procedure varies between centres and endoscopists. The aim of the present study was to describe a quality control programme for colonoscopy performance in a secondary care centre.

Starting in 2001, we established a systematic quality control programme. All patients received a questionnaire on their satisfaction with and pain during and after examination. The questionnaire was to be filled in the next day and mailed back to the centre. Pain and discomfort during and after colonoscopy and caecum intubation rate were registered as indicators of quality.

During the study period of 15 month, 1354 colonoscopies were performed by 16 endoscopists. 94% of examinations were performed without any sedation. 1054 (78%) of patients responded to the questionnaire, 99% of whom were generally satisfied. The caecum intubation rate was 82%. While 23% of patients scored for moderate pain during the examination and 16% complained of severe pain, 61% had no or only light pain. Significant differences between endoscopists regarding pain and caecum intubation rate were found in a multiple logistic regression model.

A satisfactory feedback from patients was observed, with a high response rate to the questionnaire survey and high overall satisfaction, in spite of the fact that about one third of patients experienced moderate or severe pain. There were significant variations in performance between endoscopists.