New AAAHC Institute Colonoscopy Study Finds Little Correlation Between Volume of Cases Performed and Supply Costs or Procedure Times

WILMETTE, Ill. -- The Accreditation Association for Ambulatory Health Care Institute for Quality Improvement (AAAHC Institute) has completed its fourth in a series of colonoscopy best practice studies; it finds little correlation between the volume of cases performed and supply costs or procedure times.

Colonoscopies are the second most frequently performed procedure in ambulatory care, with more than 1.1 million of the almost 1.4 million colonoscopies reported as occurring in the ambulatory setting in 1996 and 9.8 million sigmoidoscopies/colonoscopies ordered or provided in physicians' offices in 2002.  Additionally, colonoscopies are a means of detecting colorectal cancer and of preventing deaths from this second leading cause of death in the United States.

The AAAHC Institute collected real-time data from 88 organizations (representing more than 271,359 colonoscopies annually) between July to October 2004, approximately 21 (34 percent) of the organizations that participated in the AAAHC Institute's 2003 colonoscopy study also participated in the 2004 study.  Many of the "repeat" participants experienced improvements in several aspects of their procedure times.

A significant study finding supports performance measurement projections that an organization does not need a large volume of procedures to be efficient; they only need to know how to adopt the best practices.  This reduces both supply costs and performance times. The study found that the overall median procedure time was 16 minutes. The procedure times ranged from three minutes to 32 minutes. Procedure times for colonoscopy can vary by the number of polyps and other abnormalities identified and their biopsy/removal. The median pre-procedure time overall was 47 minutes.  Organizations with the shortest pre-procedure times attributed this to quick patient transfer to the ready procedure room from where much of the processing takes place. Scheduling patients far enough apart helped prevent extended waiting room time. The overall median time for discharge was 38.9 minutes. Discharge times ranged from a low of 15.3 minutes to 78 minutes.  Many of those centers with the lowest discharge times attributed the reduction to the administration of non-narcotic, fast-acting, short-duration sedatives.

Countering common perceptions that the discomfort associated with a colonoscopy may prevent many patients from using this potentially life-saving procedure for the early detection and removal of colorectal cancer, patients were generally satisfied with the procedure. To monitor outcomes, within 24-48 hours after the procedure, 84 percent of patients were contacted to obtain updates on their comfort and condition.       

The study noted that 94 percent of patient respondents in this study gave positive ratings on their overall satisfaction with their experience, and indicated low discomfort levels.

Source: AAAHC