Colonoscopy Quality Improvement: Quality Indicators and Benchmarks

Introduction Increasing efforts to reform health care and contain medical expenditures have accelerated the push to define, capture, and enforce quality measures for delivered care. This trend is evident particularly for procedural and preventative measures that can have a marked effect on patient outcomes and health care costs, such as the use of colonoscopy for screening and surveillance for colorectal cancer (CRC). Although the use of colonoscopy as a CRC screening tool has reduced patient mortality,1 variability in endoscopists’ performance, which has been demonstrated for adenoma detection rates (ADRs), assessment of bowel preparation, complication rates, use of appropriate screening and surveillance intervals, and effective polyp resection, suggest that objective measures are needed to evaluate performance and improve quality.2,3 This review discusses the current and emerging landscape regarding quality indicators and benchmarks for colonoscopy.