Abstract
Background and study aims Accreditation of endoscopy services, using valid quality indicators, may address
failures to comply with quality standards between endoscopy services. The aim of this
work was to present the Italian Society for Digestive Endoscopy (SIED) accreditation
model and its effectiveness.
Methods A team of eight endoscopists identified quality indicators derived from international
guidelines and assessed them in each center voluntarily requesting accreditation.
During a 1-day site visit, two expert endoscopists, the representative of the independent
and international administrative certification body and a professional nurse evaluated
the endoscopy center, by direct observation of the endoscopy team and examination
of the medical records
Results In all centers we noted shortcomings in instrument reprocessing. In 30 of 40 centers
(75 %) the information in the nursing charts was incomplete. Sampling for Helicobacter pylori had not been done in 12 of 40 centers (30 %). In six of 40 centers (15 %) the adenoma
detection rate for each endoscopist had not been evaluated. Post-polypectomy intervals
were inappropriate in 12 of 40 centers (30 %). We noted a statistically significant
difference (P < 0.001) between the answers to the SIED checklist of indicators submitted to the
inspection team for accreditation before the site visit and the situation found for
colonoscopy on site. As of June 30, 2018, 18 endoscopy centers had been accredited
and 10 centers had not yet being accredited because they had not completed the measures
to correct points raised at the visits.
Conclusions Numerous Italian endoscopy centers fail to meet important quality indicators. Our
accreditation program can provide means for detecting these problems and correcting
them by implementing SIED standards.
