Key performance measure	Rate of adequate bowel preparation
Description	The percentage of patients with an adequately prepared bowel
Domain	Pre-procedure
Category	Process
Rationale	It has been shown that the quality of bowel preparation affects the rates of cecal intubation and adenoma detection.
	Inadequate bowel preparation results in increased costs and inconvenience as the examination has to be rescheduled or alternative investigations have to be organized.
Construct	Denominator: Patients undergoing colonoscopy
	Numerator: Patients in the denominator with adequate bowel preparation (assessed with a validated scale, preferably the Boston Bowel Preparation Scale (BBPS; score ≥6), Ottawa Scale (score ≤7), Aronchick Scale (excellent, good, or fair))
	Exclusions: Emergency colonoscopies
	Calculation: Proportion (%)
	Level of analysis: Service and individual level
	Frequency: Continuous monitoring using novel endoscopy reporting systems should be the preferred approach;12 an alternative approach is a yearly audit of a sample of 100 consecutive LGI endoscopies
Standards	Minimum standard: ≥90%
	Target standard: ≥95%
	Bowel preparation quality, assessed using a validated scale, such as the BBPS, the Ottawa Scale, or the Aronchick Scale, should be included in every colonoscopy report.
	If the minimum standard is not reached, analysis of the factors influencing bowel preparation should be performed on a service level (information given to patients, dietary restrictions, cleansing agent used, colonoscopy timing).
	After evaluation and adjustment, close monitoring should be performed with a further audit within 6 months.
Consensus agreement	100%
PICO	1.1–1.2 (see Supporting Information)
Evidence grading	Moderate quality evidence