What Does GIQuIC Measure?

Transforming Quality Improvement from Aspirational Goals to Measurable Results

GIQuIC’s colonoscopy and EGD quality measures have been derived from the work of the ACG-ASGE Joint Task Force for the Development of GI Endoscopy Quality Indicators, published in April 2006 and updated in 2015:

Among the many quality measures tracked in GIQuIC, cecal intubation rate, average withdrawal time, and adenoma detection rate are examples that can help phsycians improve colon cancer screenings and colon cancer detection. Benchmarking of colonoscopy performance for colorectal cancer screening provides physicians valuable insight for improving both the quality and cost-effectiveness of their practice. Physicians and facilities as a whole are able to objectively compare their performance measures to other endoscopists and against the national cohort, transforming quality improvement from aspiration goals to measurable results.

Participation in GIQuIC has been demonstrated to improve overall outcomes and performance in regard to its various measures, such as adenoma detection rate, increases over time.

Adenoma Detection Rate

Adenoma detection rate, or ADR, is considered to be the most important quality indicator for a gastroenterologist and it calculates the percentage of time that at least one adenoma is detected during a colonoscopy. In fact, for every 1% increase in ADR, colorectal cancer rates decrease by 3% and morbidity decreases by 5%.1 The GI societies have set a national goal of 25% for adenoma detection rate in screening colonoscopies, for both female and male gender combined.

1 Corley DA, Jensen CD, Marks AR, Zhao WK, Lee JK, Doubeni CA, Zauber AG, de Boer J, Fireman BH, Schottinger JE, Quinn VP, Ghai NR, Levin TR, Quesenberry CP. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med. 2014 Apr 3;370(14):1298-306. doi: 10.1056/NEJMoa1309086.

Cecal Intubation Rate

One of the colonoscopy quality indicators is to advance the scope all of the way to the cecum and that is measured by cecal intubation rate.* The national standard for doing so has been set at 90% by the GI societies.

* Measure performance target based on all colonoscopies – screening, surveillance, and diagnostic procedures.

Average Withdrawal Time

Once the cecum is reached, the endoscopist will withdraw the scope while searching for adenomas. Adenomas are a type of polyp that can turn cancerous so it is important to identify and remove them during a colonoscopy. It has been determined that the withdrawal time should be no less than six minutes to ensure a thorough examination.

Colonoscopy Measures

The data fields collected by GIQuIC for the colonoscopy measures can be found in the Colonoscopy Data Collection Form.

The 11 colonoscopy measures include:

  1. History and physical documentation
  2. Informed consent documentation
  3. Adequacy of bowel prep
  4. Written discharge instructions – outpatient
  5. ASA category documentation
  6. Indication documentation
  7. Cecal intubation rate with photo documentation
    • All colonoscopies – screening, surveillance, and diagnostic
    • Screening
  8. Adenoma detection rate – screening
    • Female
    • Male
  9. Withdrawal time
  10. Immediate adverse events
  11. Appropriate surveillance interval measures

EGD Measures

The data fields collected by GIQuIC for the EGD measures can be found in the EGD Data Collection Form.

The 12 EGD measures include:

  1. Appropriate specimen acquisition in Barrett’s esophagus
  2. Appropriate management of new diagnoses of bleeding esophageal varices
  3. Appropriate endoscopic therapy for stigmata of peptic ulcer disease bleeding
  4. Appropriate anticoagulation management
  5. Appropriate antibiotic prophylaxis
  6. Helicobacter pylori status
  7. Immediate adverse events
  8. Indication documentation
  9. Written discharge instructions – outpatient
  10. Informed consent documentation
  11. History and physical documentation
  12. ASA category documentation

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