Sustained success in endoscopic performance demonstrated by the Irish National Endoscopy Quality Improvement...

Area of Science:

• Gastroenterology
• Endoscopy Quality Improvement
• Health Services Research

Background:

• The National Gastrointestinal Endoscopy Quality Improvement (NEQI) Programme in Ireland tracks over 94% of endoscopic activity.
• Over 120,000 colonoscopies are performed annually in the Republic of Ireland.
• Understanding temporal changes in colonoscopy quality is crucial for national healthcare standards.

Purpose of the Study:

• To assess national trends in colonoscopy Key Quality Indicators (KQIs) over a five-year period.
• To evaluate performance changes among low-, intermediate-, and high-volume endoscopists.
• To identify potential quality plateaus related to endoscopist procedural volume.

Main Methods:

• Retrospective analysis of colonoscopy data from the NEQI Programme (2016-2022).
• Evaluation of Key Quality Indicators: cecal intubation rate (CIR), comfort score (CS), polyp detection rate (PDR), and sedation use.
• Endoscopists categorized into low, intermediate, and high activity based on annual procedural volumes.

Main Results:

• Over 658,000 colonoscopies were analyzed, performed by 1240 endoscopists.
• Sustained improvements in KQI targets were observed across all endoscopist activity levels.
• Quality plateaus were noted for PDR (<150 procedures/year), CS (<200 procedures/year), and CIR (<250 procedures/year) when comparing experts to non-experts.

Conclusions:

• This study provides the first endoscopist-level NEQI data showing continuous KQI improvements nationwide.
• The Irish NEQI program plays a vital role in monitoring and sustaining national endoscopy performance.
• Workforce imbalances and minimum annual procedural volumes remain significant challenges for national endoscopy programs.