Achieving quality assurance standards in colposcopy practice: a teaching hospital experience

To assess the performance of the colposcopy service of the teaching hospitals of Cardiff and Vale Trust, University of Wales, Cardiff, South Wales, UK by determining if patients attending colposcopy clinic had been managed in accordance with the local departmental, regional and national (National Health Service Cervical Screening Programme) guidelines with the ultimate purpose of identifying areas for improvement in patients' care.

We retrospectively analysed the case notes of 426 women who attended the colposcopy clinic over a three-month period in 2005.

This study has shown that five of the national standards have been achieved. These relate to availability of cytology report at the time of colposcopic assessment, recording of colposcopist's impression as to the nature of the cervical lesion, suitability of biopsy samples for histological analysis, primary haemorrhage as a complication of large loop excision of transformation zone treatment and inpatient admission following this treatment. However, other five unmet standards relate to recording of visibility of squamocolumnar junction, predictability of high-grade lesion, taking a biopsy from a high-grade lesion as suggested by smear, recording consent of treatment, and number of treatments performed as an outpatient.

Our findings should lead to changes in the structure and functioning of the colposcopy clinic that would improve the detection of significant disease and the timeliness of diagnosis and the speed with which results are communicated.