{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:20:43Z","timestamp":1777612843632,"version":"3.51.4"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2002Unacceptable variation in colonoscopy quality exists. The Quality Improvement in Colonoscopy (QIC) study in 2011 improved quality by introducing an evidence-based \u201cbundle\u201d of measures into routine colonoscopy practice. The QIC bundle included: minimal cecal withdrawal time of \u2265\u200a6 minutes; hyoscine butylbromide use; supine patient position for transverse colon examination; rectal retroflexion. Colonoscopy quality was measured by adenoma detection rate (ADR). The current study measured whether these effects led to a sustained change in practice 3 years following implementation.<\/jats:p><jats:p>\n          Methods\u2002This observational study collected data from eight hospital trusts (sites) in the United Kingdom for a 6-month period, 3 years following QIC bundle implementation. Use of the antispasmodic, hyoscine butylbromide, was measured as a marker of bundle uptake. Bundle effectiveness was measured by ADR change. Comparisons were made between data before and immediately after implementation of the bundle.<\/jats:p><jats:p>\n          Results\u200228\u200a615 colonoscopies by 188 colonoscopists were studied. Hyoscine butylbromide use increased from 15.8\u200a% pre-implementation to 47.4\u200a% in the sustainability phase (P\u200a&lt;\u200a0.01) indicating sustained engagement with QIC measures. ADR was higher in the sustainability period compared with pre-intervention, but only reached statistical significance among the poorest-performing colonoscopists.<\/jats:p><jats:p>\n          Conclusions\u2002The introduction of a simple, inexpensive, pragmatic intervention significantly changed practice over a sustained period, improving colonoscopy quality as measured by ADR, particularly in poorer performers. QIC demonstrates that an easy-to-implement quality improvement approach can deliver a sustained change in practice for many years post intervention.<\/jats:p>","DOI":"10.1055\/a-1098-2101","type":"journal-article","created":{"date-parts":[[2020,3,3]],"date-time":"2020-03-03T00:11:16Z","timestamp":1583194276000},"page":"285-292","source":"Crossref","is-referenced-by-count":11,"title":["Sustained colonoscopy quality improvement using a simple intervention bundle"],"prefix":"10.1055","volume":"52","author":[{"given":"Laura J.","family":"Neilson","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, South Tyneside District Hospital, South Shields, United Kingdom"},{"name":"Northern Region Endoscopy Group, Newcastle upon Tyne, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James E.","family":"East","sequence":"additional","affiliation":[{"name":"Translational Gastroenterology Unit and Oxford NIHR Biomedical Research Centre, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Praveen T.","family":"Rajasekhar","sequence":"additional","affiliation":[{"name":"Northern Region Endoscopy Group, Newcastle upon Tyne, United Kingdom"},{"name":"Department of Gastroenterology, Northumbria Healthcare NHS Foundation Trust, North Shields, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Bassett","sequence":"additional","affiliation":[{"name":"Statsconsultancy Ltd., Amersham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Dunn","sequence":"additional","affiliation":[{"name":"Northern Region Endoscopy Group, Newcastle upon Tyne, United Kingdom"},{"name":"Department of Gastroenterology, Sunderland Royal Hospital, Sunderland, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roisin","family":"Bevan","sequence":"additional","affiliation":[{"name":"Northern Region Endoscopy Group, Newcastle upon Tyne, United Kingdom"},{"name":"Department of Gastroenterology, University Hospital of North Tees, Stockton-on-Tees, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shyju","family":"Paremal","sequence":"additional","affiliation":[{"name":"Northern Region Endoscopy Group, Newcastle upon Tyne, United Kingdom"},{"name":"Department of Gastroenterology, James Cook University Hospital, Middlesbrough, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiran","family":"Esmaily","sequence":"additional","affiliation":[{"name":"Northern Region Endoscopy Group, Newcastle upon Tyne, United Kingdom"},{"name":"Department of Gastroenterology, University Hospital of North Tees, Stockton-on-Tees, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin J.","family":"Rees","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, South Tyneside District Hospital, South Shields, United Kingdom"},{"name":"Northern Region Endoscopy Group, Newcastle upon Tyne, United Kingdom"},{"name":"Population Health Sciences Institute and Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,3,2]]},"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1098-2101.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,3,25]],"date-time":"2020-03-25T23:32:51Z","timestamp":1585179171000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1098-2101"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,2]]},"references-count":0,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2020,3,25]]},"published-print":{"date-parts":[[2020,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1098-2101","relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,2]]}}}