GI Associates Quality and Safety Measures

Measuring the quality and safety of the care we deliver is critical to MGH GI Associates’ mission to provide high-quality GI and endoscopy services to the patients and communities we serve. The American Society for Gastrointestinal Endoscopy (ASGE) has identified a set of quality measures for our highest-volume procedure, colonoscopy, which we routinely measure and monitor.1 A selection of these metrics and MGH GI Associates’ performance can be found in the table below.

All of our endoscopists receive an annual performance report comparing their individual performance in comparison with the entire practice and with national standards. Our endoscopists, with the assistance of our nursing and support staff, perform more than 14,000 colonoscopies per year, of which nearly 6,000 of these exams are performed to screen for colorectal cancer.

Measure Why is this important? National Standard GI Associates
Performance
Colonoscopy completion rates A goal of colonoscopy is to detect polyps that may lead to cancer; this measures the endoscopist’s ability to examine the entire colon. Entire colon is examined in 95% of exams Exceeds Standards
Detection of pre-cancerous polyps (Adenoma detection rate) This measures the endoscopist’s ability to find pre-cancerous polyps in patients aged 50 and older undergoing cancer screening. This detection rate has been linked to missed cancer diagnoses (higher detection rates = lower rates of missed cancers).2 25% in exams for men

15% in exams for women
Exceeds Standards

Exceeds Standards
Complications: Bleeding after polyp removal Bleeding may occur after the removal of polyps, particularly if a patient is taking certain blood-thinning medications or a large polyp is removed. Occurs in less than 1% of exams Exceeds Standards
Complications: Colon perforations Colon perforations are small holes that may occur during or following colonoscopy.  This is a very rare but serious complication of colonoscopy. Occurs in less than 0.1% of all exams Exceeds Standards
Patients recommending MGH GI Associates to others Patient satisfaction is an important indicator of the quality of services we provide; we consider whether a patient would recommend our center to a family member or friend as one of the best measures of a positive patient experience. 94% would recommend their provider/clinic to others3 Meets Standards

References

  1. DK Rex, JL Petrini, TH Baron et al. ASGE/ACG Taskforce on Quality in Endoscopy: Quality Indicators for Colonoscopy. Am J Gastroenterol 2006;101:873–885.
  2. DA Corley, CD Jensen, AR Marks et al. Adenoma Detection Rate and Risk of Colorectal Cancer and Death. N Engl J Med 2014; 370:1298-1306.
  3. National comparison data source: Publicly reported Clinician/Group Practice Consumer Assessment of Healthcare Providers (C/G CAHPS) data through 2011.

Notes:

All MGH GI Associates performance data are current for calendar year 2013. With the exception of the C/G-CAHPS survey data, all measures are collected by MGH GI Associates Quality Program.  Please contact ejcampbell@mgh.harvard.edu with any questions or comments.