Quality Program-Endoscopy (QP-E)

View brochure here.

Endoscopy is crucial for the effective management of diverse digestive problems such as gastroesophageal reflux disease, peptic ulcer disease, inflammatory bowel disease and the detection, and in some cases, the prevention of gastrointestinal cancers.  With 1.6 million endoscopic procedures performed annually in Canada it is essential that patients receive the highest quality care.  High quality endoscopy requires well‐trained healthcare professionals working in an appropriate environment with proper equipment to deliver care that is responsive to patients’ needs.


1. To develop a mechanism for continuous quality improvement in the delivery of endoscopy services in Canada.
2. To demonstrate that gastroenterologists provide quality care and quality endoscopy with available resources.
3. Based on the above, to advocate for additional resources and increased numbers of gastroenterologists.
4. To allow gastroenterologists to obtain a 'quality endorsement' for their endoscopy practice or for their endoscopy unit.
5. To support communication/liaison between gastroenterologists and endoscopy nursing staff and endoscopy unit managers, to improve the overall quality of endoscopy service delivery.
6. To demonstrate that a global assessment of endoscopy services can lead to improvements in specific outcome measures such as patient satisfaction, wait-times and resource utilization.

News Release

New national endoscopy guidelines designed to raise benchmarks for patient safety - January 23, 2012

Publication of Consensus Guidelines on Safety and Quality Indicators in Endoscopy
- Media Release (ENG) (FR)
- Backgrounder (ENG) (FR)
- Consensus Summary
- Consensus Paper

Two Main Elements of QP-E


The Canada-Global Rating Scale© (C-GRS©)

The U.K. has led the quality in endoscopy movement since 2004 when Dr. Roland Valori and team introduced the Global Rating Scale – a web-based endoscopy service evaluation tool that evaluates multiple components of endoscopy service from a patient-focused perspective. The GRS has been adapted for Canada and a Canadian website launched thanks to our U.K.colleagues.
The C-GRS© examines 12 items related to Clinical Quality and the Quality of the Patient Experience as outlined below:

- Consent process including patient information
- Safety
- Comfort
- Quality of the procedure
- Appropriateness
- Communicating results
- Equality of access
- Timeliness
- Booking and choice
- Privacy and dignity
- Aftercare
- Ability to provide feedback

For the C-GRS© publication click here.

C-GRS© Webinar Tutorial

The C-GRS© has been adopted by the Canadian Partnership Against Cancer (CPAC) and endorsed by the National Colorectal Cancer Screening Network. Click to read CPAC's briefing note and final report on the C-GRS©.


Smartphone-based Practice Audit in Gastroenterology (PAGE)

The Practice Audit in GastroEnterology (PAGE) examines consecutive outpatients undergoing colonoscopy over a two-week period. Survey questions are completed in the endoscopy suite at the time of the procedure on smartphone or the web. The audit provides information on specific colonoscopy outcome measures that serve as baseline data, allowing participants to subsequently determine the effects of their targeted improvements in the C-GRS©.

Key variables recorded include dates of referral, consultation and procedure, timing of scope insertion and withdrawal, extent of exam and quality of the bowel preparation. The website for registered users of the practice audit allows users to compare their individual results to aggregate national results.

PAGE is an Accredited Self-Assessment Program (Section Three) as defined by the Maintenance of Certification Program of the Royal College and approved by the Canadian Association of Gastroenterology for 12 hours of Section 3 credits for a total of 36 credits!

PAGE Program Evaluation
As a side project to PAGE, Drs. Catharine Walsh and Samir Grover are carrying out a program evaluation to look at the effectiveness of a short, 10-minute online video that reviews techniques endoscopists can use to modify their colonoscopy performance with the aim of improving their adenoma detection rate. Those willing to take part in this program evaluation will be randomized to either receive or not receive access to the video link. Subsequently Drs. Walsh and Grover will look at aggregated (de-identified) data from PAGE to compare colonoscopy quality metrics between those who did and did not view the video.

Please note that endoscopists not randomized to receive the video link as part of the program evaluation, can still be sent the link to view the video upon completion of the study period.

Next Steps
Endoscopists interested in taking part in PAGE colonoscopy should:
1.     Email to indicate their interest so that they can be sent further information and registered for PAGE (and be provided with a username and password).
2.     In the above email please also advise if you are willing to participate in the program evaluation (randomized to receive link to video or not).

CAG was selected to receive a 2011 Royal College of Physicians and Surgeons of Canada (RCPSC) Accredited CPD Provider Innovation Award for its practice audit program “Quality Program in Endoscopy (QP-E: colonoscopy)”.

Click here for more details.

QP-E Recognition Program

Endoscopy units participating in the QP-E and meeting the criteria of recognition program are presented with CAG’s Quality Program Recognition plaque.

To view the recipients of this plaque, click here.

How to Register for the Program

If your endoscopy team is interested in participating in the QP-E, please submit the registration form below or for more information please e-mail.

Quality-Related Education Programs

The Skills Enhancement for Endoscopy© (SEE©) Program is an educational program related to quality.