Colonoscopy completion rates: Technologies have evolved

doi:10.1136/bmj.329.7477.1287-b

BMJ 2004;329:1287 (27 November), doi:10.1136/bmj.329.7477.1287-b

Letter

Colonoscopy completion rates

Technologies have evolved

The first 150 words of the full text of this article appear below.

EDITOR—In their quality improvement report on improvingcaecal intubation rates at colonoscopy Ball et al conclude thatthese improvements were due to three key measures: increasingappointment times, allocating the procedures to the most skilledoperators, and improving bowel preparation in frail patients.¹We have several issues related to each of their interventions.

Firstly, colonoscopy appointment times were increased from 20minutes to 30 minutes. The Royal College of Physicians recommendsthat consultant gastroenterologists perform a maximum of sixcolonoscopies per notional half day (3 1/2 hours)²; 30 minutesis therefore slightly less than the suggested minimum time perprocedure. Perhaps increasing appointment times even furtherwould have resulted in even better caecal intubation rates.Moreover, an appointment shorter than the recommended lowerlimit is unlikely to be adequate for training purposes.

Secondly, although it may seem sensible to allocate colonoscopiesto the most proficient practitioners, this . . . [Full text of this article]

Peter Irving, research fellow

p.m.irving@qmul.ac.uk

Joel Mawdsley, research fellow, Richard Makins, research fellow

Research Centre for Gastroenterology, Barts and the London, Queen Mary's School of Medicine and Dentistry, London E1 2AD

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