Colonoscopy Safety and Quality

A high quality colonoscopy should be safe, effective, appropriate and accessible. This is the rationale for a safety and quality model for colonoscopy. This page explores the history of developing this model.

History of consultation

A safety and quality model for colonoscopy in Australia

In 2015, the Department of Health appointed the Commission to develop a safety and quality model for colonoscopy. The appointment was made in the context of the expanded screening of the Australian Government National Bowel Cancer Screening Program.  

Initial consultation

The Commission developed a draft safety and quality model for colonoscopy through a consultation process and a review of Australian and international experiences, from October 2015 to July 2016. The consultation included:

  • Four workshops with consumers, clinicians and health service operators, held in Melbourne, Brisbane, Perth and Sydney
  • A focus group and targeted interviews conducted with representatives of the Gastroenterological Society of Australia (GESA), the Colorectal Surgical Society of Australia and New Zealand (CSSANZ), and the Royal Australasian College of Surgeons (RACS)
  • A validation workshop involving consumers, clinicians and other stakeholders, held in May 2016, to test the principles of the draft model and recommend it for public consultation.

Stakeholders identified the need for the colonoscopy safety and quality model to address:

  • The appropriateness of the procedure and adenoma detection
  • Facilities where colonoscopy is performed
  • The training and performance of colonoscopists
  • The training and performance of other members of the clinical team (including nurses and anaesthetists)
  • Processes that support monitoring of colonoscopist procedure volume, caecal intubation, adenoma detection rates and serious adverse events.

A safety and quality model for colonoscopy

A draft model was developed incorporating three key elements:

  • A clinical care standard for the delivery of quality colonoscopy services
  • Certification and periodic re-certification of colonoscopist performance
  • Collation and review of indicators and performance targets in accordance with a standard national data set.

It was determined that the colonoscopy clinical care standard would be implemented in public and private hospitals and day procedure centres, and its implementation required under the National Safety and Quality Health Service (NSQHS) Standard 1 – Governance for Safety and Quality in Health Service Organisations.

Public consultation process 

The Commission undertook a public consultation on the safety and quality model for colonoscopy in August 2016. Submissions were received from a wide range of stakeholders including individuals, professional and peak organisations, hospitals and other health services.  

The Colonoscopy Clinical Care Standard was launched in 2018.