Lessons learned: Preventable misses and near-misses of endoscopic procedures

Table 2 Quality metrics for endoscopic procedures[11,20,21,23,24]

Colonoscopy	EGD
High quality bowel preparation (excellent, good, or adequate), documented with photos	At least 1 min of inspection per centimeter of circumferential segment of Barrett’s esophagus
Digital rectal examination prior to colonoscopy with results documented	NDR record should be considered
	When evaluating for gastric intestinal metaplasia, 5 or more biopsies need to be taken
Cecal intubation performed, landmarks noted in documentation and photos recorded	Overall, EGD evaluation for gastric intestinal metaplasia has to last 7 min or more
Withdrawal time is 6 min or more
Retroflexion, if performed, is thoroughly documented (with photographs)
Endoscopists ADR exceeds recommended thresholds. Physician participates in quality-improvement and continues to measure individual ADR

EGD: Endoscopy; NDR: Neoplasia detection rate; ADR: Adenoma detection rate.