Outpatient Surgery Magazine

Salary Survey - January 2020 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 87 of 110

bowel preparation has been shown in randomized trials to improve ADR," says Dr. Rex. This is a fundamental part of achieving high-quali- ty colonoscopy, but for whatever reason, there are still a fair number of people who don't appreciate the importance of using split prep, adds Dr. Rex. 3. High definition isn't optional. The need for a high-definition endoscope isn't up for debate if you're serious about ADR. "In this day and age, high-quality colonoscopy necessitates using HD scopes," says Dr. Keswani. "They detect adenomas at a higher rate than the older scopes." Dr. Rex agrees — and even takes it a step further. "The criti- cal thing is that high-definition resolution," he says. "You can compen- sate for having a 170-degree view instead of a 330-degree view by using excellent technique, but you cannot compensate for poor reso- lution. If you only have standard definition or there's some impair- ment of the image resolution, you simply can't compensate for that." Beyond the 'basement' High-quality colonoscopy that translates to above average ADRs essen- tially comes down to equipping skilled, knowledgeable endoscopists with high-definition scopes, measuring and benchmarking their per- formance, and ensuring that all patients use split-bowel preparations. If you do these things, there's no reason all your GI docs won't meet the minimum 25% adenoma detection rate. But why not aspire for more? "For any endoscopy doctors who are interested in high-quality colonoscopy, which should be all of us, that target ADR should be clos- er to 35%," says Dr. Keswani. "That 25% is sometimes called the 'base- ment' ADR and that 35% the 'aspirational' ADR. That's where we should all strive to be." OSM 8 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 2 0

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