Perspectives

Journal of General Internal Medicine

, Volume 25, Issue 11, pp 1230-1234

The Quality of Colonoscopy Services—Responsibilities of Referring Clinicians

A Consensus Statement of the Quality Assurance Task Group, National Colorectal Cancer Roundtable
  • Robert H. FletcherAffiliated withHarvard Medical School and Harvard Pilgrim Health Care Email author 
  • , Marion R. NadelAffiliated withDivision of Cancer Prevention and Control, Centers for Disease Control and Prevention
  • , John I. AllenAffiliated withMinnesota Gastroenterology
  • , Jason A. DominitzAffiliated withVA Puget Sound Heath Care System
  • , Douglas O. FaigelAffiliated withOregon Health and Sciences University
  • , David A. JohnsonAffiliated withEastern Virginia Medical School
  • , Dorothy S. LaneAffiliated withStony Brook University School of Medicine
  • , David LiebermanAffiliated withOregon Health and Sciences University
  • , John B. PopeAffiliated withLouisiana State University of Medicine
    • , Michael B. PotterAffiliated withUniversity of California San Francisco
    • , Deborah P. RobinAffiliated withHarvard Medical School and Harvard Pilgrim Health CareAmerican Gastroenterological Association
    • , Paul C. SchroyIIIAffiliated withHarvard Medical School and Harvard Pilgrim Health CareBoston University School of Medicine
    • , Robert A. SmithAffiliated withHarvard Medical School and Harvard Pilgrim Health CareThe American Cancer Society

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Abstract

Primary care clinicians initiate and oversee colorectal screening for their patients, but colonoscopy, a central component of screening programs, is usually performed by consultants. The accuracy and safety of colonoscopy varies among endoscopists, even those with mainstream training and certification. Therefore, it is a primary care responsibility to choose the best available colonoscopy services. A working group of the National Colorectal Cancer Roundtable identified a set of indicators that primary care clinicians can use to assess the quality of colonoscopy services. Quality measures are of actual performance, not training, specialty, or experience alone. The main elements of quality are a complete report, technical competence, and a safe setting for the procedure. We provide explicit criteria that primary care physicians can use when choosing a colonoscopist. Information on quality indicators will be increasingly available with quality improvement efforts within the colonoscopy community and growth in the use of electronic medical records.

KEY WORDS

primary care clinicians colorectal screening endoscopist colonoscopist