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194

POINT-OF-CARE DATA COLLECTION: COLONOSCOPY

D Armstrong¹, R Hollingworth², S Daniels^3
1McMaster University Medical Centre, Hamilton; ²The Credit Valley Hospital, Mississauga; ³CAG, Oakville, Ontario

BACKGROUND: Increasing adoption of colorectal cancer screening has emphasised the need for ongoing evaluation of endoscopy performance measures such as polyp detection rates. The implementation of QA programs has been hampered by the lack of user-friendly data collection techniques.
AIM: To design and test a point-of-care data collection method suitable for national, multi-site programs. The methodology should permit rapid, easy acquisition of procedural data.
METHODS: Colonoscopy-related QA questions were developed (RH, DA), programmed (SD) (ReForm™ software, MacroSolve Inc., Anyware Mobile Solutions, Tulsa) and downloaded to smartphones (Treo, Palm Inc, Mississauga) by 2 endoscopists (RH, DA) to allow data collection from colonoscopies during May-August 2007. Data were recorded: 1. Reason for colonoscopy, 2. Times of procedural landmarks (insertion, arrival at furthest extent of the exam, start of withdrawal, extubation), 3. Furthest extent of the exam (confirmed by nurse), 4. Quality of bowel preparation, 5. Number of polyps removed, 6. Complications during colonoscopy. Data were entered using touch screen/keypad by the endoscopist/nurse. On completion of each survey, data were uploaded automatically to a secure website database.
RESULTS: Complete data were collected from 67 colonoscopies.
                            

Reason for Colonoscopy; Investigate/Screening/Surveillance (n (%))	18 (27) /34 (51) /15 (22)
Cecal Intubation / Terminal ileum inspected	66 (99%) / 43 (64%)
Insertion Time; mean/median/[range] (mins)	11/9 [2-62]
Withdrawal Time; mean/median/[range] (mins)	7/6 [1-24]
Quality of bowel prep - Ottawa Score (max=14); mean [range]	2.2 [0-10]
Number of polyps removed; 0, 1, 2, 3, 4, 5, 6 or more (n)	46 /15 /2 /0 /0 /1 /3
Complications During Colonoscopy	0

DISCUSSION: This study demonstrates that accurate, time-stamped data can be acquired and downloaded easily/automatically and avoids the inefficiencies of paper-based data entry systems (collection, collation, data re-entry). The central server permits real-time monitoring of progress. Surveys can be designed and revised easily for immediate download to participants’ smartphones.
CONCLUSION: Multi-site, point-of-care, smartphone-based data collection is feasible. This approach has considerable potential for practice audit and QA programs and associated professional education and development programs.
Support for this research was provided by the CAG

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