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

ASGE open access endoscopy

Pdf Summary

The guideline document prepared by the American Society for Gastrointestinal Endoscopy (ASGE) discusses open-access endoscopy (OAE), which allows referring physicians to request endoscopic procedures without prior clinic consultations. This approach aims to increase efficiency and reduce costs associated with unnecessary consultations, particularly for procedures where the need is clear, like colorectal cancer screenings.<br /><br />The document reviews the appropriateness of referrals within the OAE system, finding variable rates of appropriateness and a higher incidence of inappropriate referrals by non-gastroenterologists. It emphasizes that while guidelines assist in determining when a procedure is appropriate, decisions should be tailored to individual patient contexts, as some deemed "inappropriate" may still be justified. It highlights a performance target for appropriate indications of over 80% for all procedures, emphasizing the quality benchmark for ERCP due to potential serious adverse events.<br /><br />The document stresses that while the OAE model accelerates procedure scheduling, patient education and informed consent remain critical. Patients should be adequately informed, and pre-procedure assessments should be conducted, with informed consent ideally obtained the same day as the procedure. Issues like patient readiness, referral appropriateness, and follow-up communication are critical to the model's success. The guidelines recommend that all results and recommendations post-procedure should be communicated to both patients and referring doctors.<br /><br />Lastly, the guideline underlines the importance of comprehensive patient records and communication between healthcare providers to ensure safety and efficacy, suggesting that pre-procedure consultation might still be beneficial in cases of complex medical history or uncertain procedural indication. The ASGE encourages adaptations of these guidelines as new data and technologies emerge.

Keywords

open-access endoscopy

ASGE guidelines

colorectal cancer screenings

referral appropriateness

patient education

informed consent

ERCP quality benchmark

procedure scheduling

healthcare communication

patient records