Safety and Quality > Our Work > Clinical Care Standards > Colonoscopy Clinical Care Standard

The Commission is currently developing a Colonoscopy Clinical Care Standard, as a key component of a national safety and quality model for colonoscopy.

Background

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.

Rationale

A high quality colonoscopy should be safe, effective, appropriate and accessible.

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 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.

Safety and Quality Model for Colonoscopy Services in Australia

The draft model incorporated three key elements:

  • A Colonoscopy Clinical Care Standard (CCS) for the delivery of high quality 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.

The Colonoscopy CCS provides guidance on the best evidence based care delivered in day procedure hospitals, private hospitals and public healthcare services. Implementation of evidence based best practice is required under the Clinical Governance Standard in the second edition of the National Safety and Quality Health Service (NSQHS) Standards.

The first edition of the  National Safety and Quality Health Service (NSQHS) Standards is available here. 

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

In June 2017, the Australian Government Department of Health accepted the model.

Colonoscopy Clinical Care Standard

The Commission is now working with the Colonoscopy CCS Topic Working Group, consisting of clinical experts and consumers, to develop the draft Colonoscopy CCS. The Colonoscopy CCS relates to the care of adult patients undergoing colonoscopy for surveillance and diagnosis. It covers management from the initial referral for colonoscopy though to follow-up post procedure.

The development of the Colonoscopy CCS will assist health services address service provision disparities contained in the First Australian Atlas of Healthcare Variation

Public consultation

Public consultation on the draft Colonoscopy CCS and associated documents was conducted from 27 November until 29 December 2017.

 

Next steps

The Commission is currently reviewing all feedback and will use this analysis to finalise the clinical care standard.

If you have any questions about the Colonoscopy Clinical Care Standard please email ccs@safetyandquality.gov.au