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Tinmouth, Jill, MD, PhD, FRCPC; Patel, Jigisha, MSc; Hilsden, Robert J., MD, PhD, FRCPC; Ivers, Noah, MD, PhD; Llovet, Diego, PhD
Baillière's best practice & research. Clinical gastroenterology, 06/2016, Volume: 30, Issue: 3Journal Article
Abstract There is considerable variation in the quality of colonoscopy, attributable in part to endoscopist performance. Audit and feedback (A&F) provides health professionals with a summary of their performance over a period of time and is a common strategy used to improve provider performance. In this review, we discuss current understanding of the mechanism of A&F and describe specific features of effective A&F. To date, trials of A&F to improve colonoscopy performance report heterogeneous results, in part because colonoscopy is a complex procedural skill but also because the quality improvement interventions were sub-optimally implemented or inadequately evaluated. Nonetheless, evidence from a wide range of literature suggests that A&F has the potential to improve endoscopist performance. We discuss future directions for research in this area and provide guidance for providers or health system planners wishing to implement A&F to address quality of colonoscopy in their practice and/or jurisdiction.
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