Improving Colonoscopy Quality for Colorectal Cancer Screening in the National VA Healthcare System

We created an innovative informatics framework for centralized reporting of colonoscopy quality across the VA, facilitating the implementation of the VA Endoscopy Quality Improvement Program (VA-EQuIP). The VA-EQuIP quality dashboard (updated at 6 month intervals) provided adenoma detection rates (ADR), bowel preparation quality, and cecal intubation rate to every facility.This initiative directly addressed the OIG's recommendations and the VA's urgent need for evidence-based colonoscopy quality measurement and reporting. Through VA-EQuIP, we provided bi-annual audits and feedback on colonoscopy quality for VA sites and endoscopists, along with individual provider benchmarking against local and national performance standards. Additionally, we organized collaborative learning sessions led by national experts in colonoscopy training and quality. These sessions focused on shared learning, featuring lectures, discussions, skill-building activities, and work on quality improvement projects.