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Canadian Journal of Gastroenterology
Volume 25, Issue 10, Pages 547-554
Original Article

Development and Implementation of a Comprehensive Quality Assurance Program at a Community Endoscopy Facility

Robert J Hilsden,1,2,3 Alaa Rostom,1,2,3 Catherine Dubé,1,2,3 Darlene Pontifex,1 S Elizabeth McGregor,3,4 and Ronald J Bridges1,2

1Forzani & MacPhail Colon Cancer Screening Centre, Alberta Health Services, Canada
2Department of Medicine, University of Calgary, Canada
3Department of Community Health Sciences, University of Calgary, Canada
4Population Health Research, Alberta Health Services, Calgary, Alberta, Canada

Received 23 March 2011; Accepted 1 April 2011

Copyright © 2011 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Quality assurance (QA) is a process that includes the systematic evaluation of a service, institution of improvements and ongoing evaluation to ensure that effective changes were made. QA is a fundamental component of any organized colorectal cancer screening program. However, it should play an equally important role in opportunistic screening. Establishing the processes and procedures for a comprehensive QA program can be a daunting proposition for an endoscopy unit. The present article describes the steps taken to establish a QA program at the Forzani & MacPhail Colon Cancer Screening Centre (Calgary, Alberta) – a colorectal cancer screening centre and nonhospital endoscopy unit that is dedicated to providing colorectal cancer screening-related colonoscopies. Lessons drawn from the authors’ experience may help others develop their own initiatives. The Global Rating Scale, a quality assessment and improvement tool developed for the gastrointestinal endoscopy services of the United Kingdom’s National Health Service, was used as the framework to develop the QA program. QA activities include monitoring the patient experience through surveys, creating endoscopist report cards on colonoscopy performance, tracking and evaluating adverse events and monitoring wait times.