Prospective audit of colonoscopy quality in Kent and Medway, UK

To compare the quality of colonoscopy in the Kent and Medway Strategic Health Authority with national standards and previous audits.

A prospective 12-month audit of colonoscopy quality as assessed by number of procedures performed, total colonoscopy rates, sedation usage, and complications. Data were collected by 7 endoscopy units on 5905 colonoscopies performed by 62 colonoscopists. The endoscopy unit nurses, as opposed to the colonoscopists, verified that colonoscopy was total.

Seven doctors stopped performing colonoscopy during the study period. Thirty-nine of 55 colonoscopists (71 %) achieved total colonoscopy in at least 90 % of cases; 12 (22 %) completed colonoscopy in 80 - 89 % of their cases and 4 (7 %) in 79 % or less of their cases. Seventy-nine percent of colonoscopists used sedation in accordance with British Society of Gastroenterology (BSG) guidelines. Only 22 of 55 (40 %) of colonoscopists performed more than 100 colonoscopies during the 12-month audit period. Reported complications were below expected levels.

In our study almost one-third of colonoscopists did not achieve colonoscopy completion rates of at least 90%, and less than half performed more than 100 colonoscopies during the 12 month study. Adherence to quality standards appears to be inadequate.