ASGE Annual GI Advanced Practice Provider Course - Day One | July 2021-01

01_Fundamentals of the GI Consult-Kaul

Pdf Summary

The ASGE Annual Advanced Practice Provider (APP) Course focuses on the fundamentals of the GI consult. The role of a GI consultant is to provide sub-specialty level assessment and recommendations based on specific clinical questions posed by referring providers. The consultant receives consultations through various channels and triages them based on urgency. In the outpatient setting, the consultant may collaborate with APPs for initial triaging. In the inpatient setting, the consultant coordinates with attending physicians or fellows. Key considerations for a GI consult include determining its urgency and the patient's condition. The consultant must ask critical questions at the beginning of the consult to gather relevant information. The principal elements of a GI consult include record and imaging review, medication reconciliation, review of systems, focused review of GI-specific symptoms, detailed physical examination, patient education, and clear assessment and plan documentation. An ideal consultant is known for their good reputation, compassion, responsiveness, and cognitive competence. Strategies for APPs as GI consultants include clarifying consult questions, consulting with colleagues, communicating urgent findings, building relationships, and reviewing and preparing for referrals in advance. The use of e-consults, which enable PCPs to request specialty input for low complexity clinical issues, can increase efficiency and availability of specialists while reducing costs. eConsults have been used in the ambulatory setting and more frequently for hospitalized patients during the COVID-19 pandemic. The consult note should include endoscopic procedure risk stratification, recommendations regarding peri-procedure medication adjustments, discussion of informed consent, and documentation consistent with the level of billing. The responsibility of the GI consultant does not entail a complete review of all medications the patient has ever taken.

Keywords

GI consult

sub-specialty level assessment

referring providers

outpatient setting

inpatient setting

urgency

patient's condition

consult strategies

e-consults

medication review