Improving Colonoscopy Quality for Colorectal Cancer Screening in the National VA Healthcare System

Conditions

• Colorectal Neoplasms

Eligibility Criteria

Sex

ALL

Age

18 Years - N/A

Healthy Volunteers

Accepted

Interventions

• Veterans Affairs Endoscopy Quality Improvement Program (VA-EQuIP) — OTHER
  We created an innovative informatics framework for centralized reporting of colonoscopy quality across the VA, facilitating the implementation of the VA Endoscopy Quality Improvement Program (VA-EQuIP). The VA-EQuIP quality dashboard (updated at 6 month intervals) provided adenoma detection rates (ADR), bowel preparation quality, and cecal intubation rate to every facility.This initiative directly addressed the OIG's recommendations and the VA's urgent need for evidence-based colonoscopy quality measurement and reporting. Through VA-EQuIP, we provided bi-annual audits and feedback on colonoscopy quality for VA sites and endoscopists, along with individual provider benchmarking against local and national performance standards. Additionally, we organized collaborative learning sessions led by national experts in colonoscopy training and quality. These sessions focused on shared learning, featuring lectures, discussions, skill-building activities, and work on quality improvement projects.

Study Details

High quality screening colonoscopy is critical for colorectal cancer (CRC) prevention in Veterans. There is significant variability in colonoscopy quality in VA that is directly linked to differences in CRC incidence and death. The investigators developed the VA Endoscopy Quality Improvement Program (VA-EQuIP) that the National GI program office will implement using centralized quality measurement and reporting for adenoma detection rates (ADR), bi-annual audit and feedback with provider benchmarking to local and national performance, and collaborative learning to support colonoscopy quality improvement. Using a cluster randomized controlled trial, the investigators will study the implementation of VA-EQuIP and determine the efficacy of its intervention on adenoma detection rates, which are directly linked to CRC incidence and death.

Key Dates

Start date

Jun 1, 2020

Status verified

May 2025

Primary completion

Mar 29, 2024

Completion

Mar 29, 2024

Study Design

Enrollment

445 participants (actual)

Arms

• Arm: Endoscopy Providers
  In the primary analysis model, there were 68 sites with usable data with 98,442 procedures from 445 providers in the pre-intervention time frame and 129,972 procedures from 392 providers in the post-intervention time frame.

Primary Outcome Measure

Provider Adenoma Detection Rate (for All Colonoscopies) [ Time Frame: Our intervention effect was estimated with the pre-intervention timepoint defined as 1/1/21 through dashboard release at the site, and post-intervention timepoint defined as beginning 3 months post dashboard release and concluding 6/30/23. ]

Locations (6)

Find similar trials in San Diego, CA

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