Strategies to Improve Quality of Screening and Surveillance Colonoscopy - AGA Guidelines 1. Adequate bowel preparation. 2. Use split dose preparation. 3. Bowel prep instructions written at a 6th grade level in the patient's native language. 4. Use high definition colonoscopes 5. Cecal intubation rates ≥ 90%. 6. Mean withdrawal times among normal colonoscopies ≥ 6 min. 7. A second look of the right colon in retroflexed or forward view should be performed to increase polyp detection. 8. Provide feedback on adenoma detection rate annually or when endoscopists have accrued 250 screening colonoscopies. 9. Goal adenoma detection rate is ≥ 30% 10. Goal serrated lesion detection rate is ≥ 7% polyps 11. Cold snare is used for non-pedunculated 3-9 mm in size. Jumbo forceps can be useful for polyps ≤ 2mm in size. 12. Complex polyps that do not have malignant endoscopic features should go for endoscopic resection rather than surgery. 13. Document colonoscopy with detailed report including procedure indication, extent of examination, bowel preparation quality, findings and interventions, and follow-up plan. 14. Inform patients of potential adverse events, warn symptoms, and emergency contact information. 15. Follow current guidelines to assign appropriate screening and surveillance intervals. By Dr Cindy Ye @EmoryGastroHep #Colonoscopy #Screening #quality #AGA #Guidelines #management #gastroenterology
