Froehlich, E., Muller, R., and Leiss, O. (2010) Colonoscope reprocessing : Problems – implementation of a nationwide quality assurance system - results. Verdauungskrankheiten, 28 (2). pp. 69-77.

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Abstract

International studies in the 90's and the HYGEA Study from Germany in 2002 revealed prevalences of around 50% of microbiological contaminations in reprocessed flexible endoscopes. Before introducing the colorectal cancer screening program by colonoscopy in Germany in 2002, the Kassenarztliche Bundesvereinigung (KBV) and the key stakeholders of the public health insurance system agreed on a quality assessment assurance for reprocessing endoscopes where the qualification for refund for colonoscopies from the public health system was made conditional on adequate qualifications of the gastroenterologist; on a minimum number of performed procedures per year; and on adequate endoscope reprocessing documented by negative surveillance cultures 2 times per year. This study is an implementation and outcome evaluation of the quality assessment assurance in colonoscopy in Germany. The analysis of the data obtained from the KBV (the number of endoscopic units performing therapeutic and/ or screening colonoscopies within each local KV; the results of all microbiological surveillance tests of reprocessing quality; the number of failed surveillance tests and re-tests) shows that the percentages of actually performed microbiological control tests (out of those prescribed by the assurance system) reached already 95% in 2004 and remained above or close to this level thereafter. After the introduction of the quality assessment assurance, the percentage of failed microbiological surveillance tests dropped significantly and steadily from close to 17% in 2003 to below 4% in 2007. This study evidences the successful implementation of the quality assessment assurance in ambulance offices and a substantial improvement in the quality of reprocessing flexible endoscopes achieved by these measures with a drop from 50% of failed tests observed before the introduction in 2000 - 2001 to below 4% in 2007.

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