The importance of high quality colonoscopy is widely recognized, however, it is challenging to measure its quality for an entire population. The aim of this study is to measure on 9 key colonoscopy quality indicators for all practicing endoscopists in Ontario, Canada in 2015. Using linked health administrative databases, colonoscopies performed between Jan. 1 and Dec. 31 2015 were identified. Endoscopists were defined as those who had performed ≥6 colonoscopies in this period. We measured 9 quality indicators at the endoscopist level: annual colonoscopy volume, polypectomy rate, cecal intubation rate, polypectomy-associated bleeding, perforations, colorectal cancers (CRC) detected, post-colonoscopy CRCs (PCCRC), poor bowel preparation rate and colonoscopies with recent normal findings (% colonoscopies in 2015 where a 2nd normal and complete colonoscopy was done in the prior 3 years). Provincial rates and median endoscopist values were reported. For less frequent events, the proportion of endoscopists is reported by number of events. In 2015, 921 endoscopists performed 464,506 colonoscopies in Ontario. Among the endoscopists, 20% were women; 57% were surgeons, 33% were gastroenterologists and 10% were internists or other practitioners. 64% practiced in hospitals, 11% practiced in private clinics and 25% practiced in both settings. See Tables 1 & 2 for quality indicators. We have found that Ontario endoscopists performed well in 2015, although there is still room for improvement. These indicators will be used in centralized, province-wide provider performance reporting with the goal of improving colonoscopy quality across the province. Table 1: Provincial rates and median endoscopist values for colonoscopy quality indicators a=Unable to calculate provincial rate as volume is calculated per endoscopist; b=Events infrequent, therefore median is zero. See table 2. Canadian Cancer Society Research Institute
