December 30th, 2012
Quality Colonoscopy: How do you let your patients know you meet the mark?
Colonoscopy prevents most colorectal cancers, but only when it is performed as part of a high-quality examination. The quality measures most often discussed include cecal intubation rate, cecal withdrawal time, documentation of bowel prep quality in endoscopy reports, adenoma detection rate (ADR), and appropriate recommendation of subsequent screening or surveillance intervals after colonoscopy. While third-party payers are increasingly considering using some of the above as pay-for-performance measures, I have also noticed many more patients asking about some of these measures when they are being consented for a colonoscopy. This leads me to ask you the following.
1) Do you routinely inform your patients of your ADR, cecal intubation rate, and/or withdrawal time?
2) Do you follow guidelines regarding repeat colonoscopy intervals (i.e., 10 years for normal-risk patients with a normal exam, 5-10 years for 1-2 small adenomas, etc.)?
3) Do you document bowel prep quality on your reports, and if so, do you use a validated method such as the Boston Bowel prep score?
4) Are these above measures available on your website or posted in your office?
5) For those of you who do not do some or all of the above, why don’t you?
6) Do you think patients care about these facts?
I am looking forward to an interesting conversation.