Table 1.

 Continuous quality improvement targets

(1) Completion of adequate follow up colonoscopy on more than 90% of patients in whom it is indicated. (C)

(2) Knowledge of recommended screening intervals and adherence to practice guidelines. (C)

(3) Adequate documentation of all lesions found on FS, allowing the colonoscopist to complete removal of unremoved lesions. (C)

(4) Annual performance reviews of clinicians performing FS, measuring complications, depth of insertion, and detection of polyps and cancer. (C)

(5) Identification and appropriate reaction with respect to anticoagulation and antibiotic prophylaxis. (E)

(6) Average depth of sigmoidoscope insertion stating whether level reached is maximal insertion or after straightening the endoscope. (C)

(7) Documentation in endoscopic report of depth of insertion in cm (100%). (C)

(8) Patient satisfaction with the FS experience, including level of discomfort with the procedure (approximately 70% should be satisfied with the procedure). (E)

(9) Documentation of quality of bowel preparation. Goal = 100%. (E)

(10) Documentation of informed consent. Goal = 100%. (E)

(11) Complication rates following biopsy and polypectomy at FS. (E)

(12) Development and adherence to guidelines for the performance of FS by non-physicians, including training, supervision, and ongoing proctoring. (C)

(13) Knowledge of ASGE-SGNA guidelines on flexible endoscope reprocessing. (E)

(14) Compliance with policies for endoscope reprocessing. (E)

FS, flexible sigmoidoscopy; (C), consensus based recommendation; (E) evidence based recommendation; ASGE, American Society of Gastrointestinal Endoscopists; SGNA, Society of Gastroenterology Nurses and Associates.