Clinical care standard indicators: colonoscopy
Indicator Set Attributes
Identifying and definitional attributes
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The Australian Commission on Safety and Quality in Health Care has produced these indicators to assist with local implementation of the Colonoscopy clinical care standard (ACSQHC 2018).
The Colonoscopy clinical care standard relates to the care of adults undergoing colonoscopy for screening, diagnosis, surveillance, or treatment. It covers the period from when a patient is referred for consideration of colonoscopy through to discharge including planning for follow-up care. The Colonoscopy clinical care standard is relevant to the care provided in primary and acute healthcare settings, including general practice, and public and private hospitals including day procedure services.
A clinical care standard is a small number of quality statements that describe the clinical care that a patient should be offered for a specific clinical condition. The indicators included in this specification are a tool to support local clinical quality improvement and may be used to support other quality assurance and peer review activities. The indicators have been specified to align with the performance indicators that form part of the certification and recertification processes led by the Conjoint Committee for the Recognition of Training in Gastrointestinal Endoscopy (CCRTGE), a national body comprising representatives of the Royal Australasian College of Physicians (RACP), the Gastroenterological Society of Australia (GESA), and the Royal Australasian College of Surgeons (RACS).
The quality statements that are included in the Colonoscopy clinical care standard are as follows:
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Supersedes Clinical care standard indicators: colonoscopy
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Colonoscopy clinical care standard indicators: 1-Proportion of patients scheduled for a colonoscopy whose bowel preparation was adequate
Colonoscopy clinical care standard indicators: 2-Proportion of patients undergoing a colonoscopy who have their entire colon examined
Colonoscopy clinical care standard indicators: 3-Proportion of patients who had a colonoscopy that detected one or more adenoma(s)
Colonoscopy clinical care standard indicators: 4-Proportion of patients who had a colonoscopy that detected one or more sessile serrated adenoma(s) or sessile serrated polyp(s)
Collection and usage attributes
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This indicator specification has been developed to assist with the local implementation of the Colonoscopy clinical care standard (ACSQHC 2018). These indicators are intended for local use by colonoscopists, to monitor their results over time and support quality assurance processes.
Most of the data required by the indicator specifications cannot be sourced from routine collections. Colonoscopists will need to conduct prospective collections or retrospective medical records audits of all patients undergoing colonoscopy, for a specific time period. For most of the indicators, the time frame over which data are collected, or sourced from medical records, will be guided by the expected sample size. Samples need to be large enough to identify a change in compliance with the quality statement that is deemed meaningful between audit periods. This will vary by indicator.
Monitoring the implementation of the Colonoscopy clinical care standard will assist in meeting some of the requirements of the National Safety and Quality Health Service (NSQHS) Standards (ACSQHC 2017).
Source and reference attributes
Australian Commission on Safety and Quality in Health Care
Australian Commission on Safety and Quality in Health Care 2017. National Safety and Quality Health Service Standards. 2nd ed. Australian Commission on Safety and Quality in Health Care, Sydney. Viewed 4 September 2019, https://www.safetyandquality.gov.au/wp-content/uploads/2017/12/National-Safety-and-Quality-Health-Service-Standards-second-edition.pdf
Australian Commission on Safety and Quality in Health Care 2018. Colonoscopy clinical care standard. Australian Commission on Safety and Quality in Health Care, Sydney. Viewed 4 September 2019, https://www.safetyandquality.gov.au/wp-content/uploads/2018/09/D18-31374-Colonoscopy-Brochure-WEB-version-SEP-2018.pdf