Different quality indicators have been proposed by the European Society of Gastrointestinal Endoscopy (ESGE) guidelines, to measure and evaluate quality in colonoscopy and ERCP. In this study, we aimed to assess the ability to evaluate these performance measures following the introduction of their mandatory documentation within a dedicated reporting system in a tertiary hospital endoscopic unit.

We retrospectively reviewed the electronic database of the Gastroenterology Department of a tertiary hospital and retrieved all colonoscopy (n=2824) and ERCP reports (n=453) performed between 30/6/2024 and 1/7/25. ESGE recommended quality indicators were assesses for both procedures.

The reporting system enabled systematic recording and measurement of the following colonoscopy quality indicators: adequate bowel preparation (Boston Bowel Preparation Scale [BBPS score ≥ 6]) 93.4% (95%CI 92.3%-94.5%), indication for colonoscopy 95,8% (95%CI 95%-96,5%), cecal intubation rate: 96.2% (95%CI 95.4%-97%), Adenoma detection rate (ADR) based on optical diagnosis 37.7% (95%CI 35.4%-39.9%), polyp detection rate (PDR): 45.3% (95%CI 43%-47.6%), appropriate polypectomy technique 94.1% (95%CI 92.7%-95.4%). However although the reporting system had the capacity to capture additional  indicators specifically: complication rates, patients experience and appropriate post-polypectomy surveillance, these fields were not completed by endoscopists, preventing extraction analysis of these measures.

For ERCP the following performance measures were measurable: bile duct canulation rate 92.1% (95%CI 89.6%-94.5%), clearence of common bile duct stones <10mm, 91.1% (95%CI 86%-96.1%), stent placement in biliary obstruction 95.9% (95%CI 92.2%-98.9%). Despite the system’s ability to record on other indicators including adequate antibiotics prophylaxis before ERCP, ERCP- related complications  and post-ERCP pancreatitis, these fields were not consistently completed by the endoscopists, preventing extraction analysis of these measures.

Standardized monitoring of quality indicators for endoscopic procedures (colonoscopy and ERCP) has been incorporated into the electronic database system of the Endoscopy Unit as mandatory fields. Making this fields a prerequisite for report completion by the operating endoscopist, represents an effective strategy for systematically capturing, monitoring and assessing quality indicators. Implementation of this process is expected to markedly improve the quality of services provided and enhance patient safety.