GI Unit Leadership: Optimizing Endoscopy Operations through Leadership (On-demand)

15_Keswani_New Technology

Pdf Summary

Dr. Rajesh N. Keswani, an associate professor and Director of Quality at Northwestern University's Digestive Health Center, provides guidance on introducing new endoscopic technologies safely and effectively. His presentation emphasizes the importance of implementing structured processes when adopting new technologies such as lumen apposing metal stent placement, radiofrequency ablation, or endoscopic suturing in medical units.<br /><br />Dr. Keswani, who consults for Boston Scientific and Medtronic, suggests first understanding the potential reasons for adopting new technology, including improved efficacy, safety, cost-effectiveness, or increased patient referrals. He identifies common scenarios where physicians might want to introduce new devices, often influenced by manufacturer promotions without adequate preparation or evaluation by the unit.<br /><br />To address these challenges, Dr. Keswani recommends developing formal policies and procedures. These should include the removal of bias, thorough evaluation by a designated committee, and transparent decision-making processes. He stresses the importance of involving all stakeholders, including physicians and support staff, in the decision-making to ensure adequate training and prepare for any potential risks associated with new technologies.<br /><br />Training and safety measures should include comprehensive in-services for physicians, nurses, and technicians before proceeding with new equipment. It's crucial to establish a policy for ongoing assessment and refresher courses to maintain skill levels.<br /><br />For privileging new techniques, Dr. Keswani outlines the need for clear institutional policies, as well as criteria for credentialing and privileging practices. These steps should involve rigorous training, especially for complex or high-skill procedures, ensuring that healthcare units can perform these techniques proficiently and safely. <br /><br />In summary, careful planning and structured processes are essential for the safe implementation of emerging endoscopic technologies, requiring attention to efficacy, safety, cost, and comprehensive training.

Keywords

endoscopic technologies

lumen apposing metal stent

radiofrequency ablation

endoscopic suturing

structured processes

training and safety

credentialing

privileging practices

healthcare units

stakeholder involvement