Endoscopy audit over 10 years in a community hospital in Egypt

Abstract

Background: Practice variation is likely to have an important impact on the effectiveness of endoscopy. Performing regular quality audits allows identification of potential underperformance and consequently can result in significant improvement in endoscopy quality. An annual audit was conducted in a community hospital in Egypt.

Aim: The aim of the study was to determine if practice and performance of endoscopy is influenced by a consistent audit process by looking for improvement in completeness of procedures over a 10-year period.

Patients and methods: A total of 3736 consecutive procedures were prospectively assessed between years 2004 and 2014.

Results: The completion rates improved consistently. Esophagogastroduodenoscopy (EGD) completion rate was 99.9% in 2004–2008 and 99% in 2009–2013 (P = 0.5). Initial hemostasis of EGDgastrointestinal bleed increased from 82% in 2004–2008 to 86% in 2009–2013 (P = 0.04). Adequate bowel cleansing increased from 60% in 2004–2008 to 67% in 2009–2013 (P = 0.13). Crude completion rates increased from 66% in 2004–2008 to 79% in 2009–2013 (P = 0.007). Adjusted completion rates increased from 80% in 2004–2008 to 95% in 2009–2013 (P = 0.0001). Ileoscopy rates in patients with chronic diarrhea increased from 79% in 2004–2008 to 97% in 2009–2013 (P = 0.01). Endoscopic polypectomy rates increased from 65% in 2004–2008 to 94% in 2009–2013 (P = 0.0004). Complete polyp removal rates increased from 77% in 2004–2008 to 87% in 2009–2013 (P = 0.19). Complete polyp retrieval rates increased from 85% in 2004–2008 to 89% in 2009–2013 (P = 0.34).

Conclusion: Continuous audit over 10 years can enhance endoscopy performance, improve the quality of endoscopic procedures and lead to better outcomes.

Keywords: Endoscopy, Audit, Quality, Egypt