An Italian prospective multicenter study on colonoscopy practice and quality: What has changed in the last 10 years

Background: A relevant number of adenomas can be missed during colonoscopy. Aims: Assess the current status of colonoscopy procedures in Italian centers. Methods: A prospective observational study involving 17 hospitals (34 endoscopists) included consecutive patients undergoing standard colonoscopy. In the first phase, endoscopists performed consecutive colonoscopies. In the second phase, retraining via an online learning platform was planned, while in the third phase data were collected analogously to phase 1. Results: A total of 3,504 patients were enrolled. Overall, a BBPS score ≥6 was obtained in 95.6% of cases (94.8% and 96.9% in the pre- and post-training phases, respectively). 88.4% of colonoscopies had a withdrawal time ≥6 min (88.2% and 88.7% in the pre- and post-training phases). Median adenoma detection rate (ADR) was 39.1%, with no significant differences between the pre- and post-training phases (40.1% vs 36.9%; P = 0.83). In total, 81% of endoscopists had a ADR performance above the 25% threshold. Conclusion: High colonoscopy quality standards are achieved by the Italian hospitals involved. Quality improvement initiatives and repeated module-based colonoscopy-training have been promoted in Italy during the last decade, which appear to have had a significant impact on quality colonoscopy metrics together with the activation of colorectal cancer screening programs

The contribution of public-private partnership (PPP) to sustainability: governance and managerial implications from a literature review

Purpose – Based on the theoretical background of stakeholder capitalism, the purpose of this paper is to contribute to the scientific debate on the topic of public–private partnerships (PPPs), considering in particular how this governance structure relates to the pursuit of sustainable development. Specifically, this objective will be pursued with a focus on stakeholder relations and governance aspects, to highlight enablers and barriers in change for sustainability. Design/methodology/approach – The systematic literature review is applied starting with the use of keywords in Web of Science, which leads to the extrapolation of 629 articles on the topic of ‘‘PPP and sustainability’’. Subsequently, through various skimming steps, 75 papers are sampled. A mixed (quantitative-qualitative) approach is then followed: a co-word semantic network to identify the pattern of discourse and a more in-depth and explanatory analysis of the papers. These quantitative and qualitative tools synergistically work together to evidence the main aspects related to the aim of the paper. Findings – With reference to the governance structure and stakeholders of PPPs, the analyses highlight the shift towards a triadic type of relational governance that considers stakeholders (especially the community) in addition to public–private partners. This can improve the partnership’s performance (particularly in sustainable development) and social legitimacy. With reference to the role of PPPs in the implementation of sustainable development, they have positive potential in terms of implementing sustainability and raising stakeholder awareness of it. Nevertheless, PPPs may entail risks to the implementation of sustainability. The findings lead to some concluding remarks on future research opportunities. Research limitations/implications – The research leads to some managerial implications, such as the need to follow a competitive collaboration approach among stakeholders, to develop relational governance skills and related managerial tools and to incorporate sustainability aspects starting from the design of PPPs. Originality/value – The originality aspect of this research is the consideration of a PPP by relating it to the pursuit of sustainability. Such an inter-organizational structure could be suitable to deal with the complexity inherent in the implementation of sustainability and is peculiar in terms of governance and stakeholder relations, considering that it is characterised by the presence of several partners of different nature (public and private)