Unlocking quality in endoscopic mucosal resection

Abstract

A review of the development of the key performance metrics of endoscopic mucosal resection (EMR), learning from the experience of the establishment of widespread colonoscopy quality measurements. Potential future performance markers for both colonoscopy and EMR are also evaluated to ensure continued high quality performance is maintained with a focus service framework and predictors of patient outcome.

Keywords: Endoscopic mucosal resection; Colonoscopy; Quality in endoscopy; Advanced therapeutic endoscopy; Large non pedunculated colorectal polyps; Key performance indicators

Core Tip: Colonoscopy quality and key performance indicators (KPIs) are a mainstay of endoscopy practice. Adherence to colonoscopy KPIs is important for trainees and consultant endoscopists and is closely linked to patient outcomes. High quality colonoscopy often yields complex polyps, the management of which is now primarily endoscopic. Endoscopic resection of complex polyps thus requires similar scrutiny to diagnostic colonoscopy, to ensure consistent standards are applied. In this review, we discuss existing colonoscopy quality indicators, evaluate some potential new markers and the evidence base for KPIs in the management of complex polyps.