GI Unit Leadership: Shaping a High-Performing Endoscopy Unit (On-Demand) | February 2026-ASGE ACG quality indicators

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This document from the American Society for Gastrointestinal Endoscopy (ASGE) and the American College of Gastroenterology (ACG) outlines quality indicators applicable to all gastrointestinal (GI) endoscopic procedures. It builds on prior versions (2006 and 2015) and is designed to guide endoscopists and practices in quality improvement efforts, emphasizing key domains—preprocedure, intraprocedure, and postprocedure.<br /><br />Quality indicators assess structural, process, and outcome measures related to endoscopy, with performance targets mostly set at 98%, indicating these standards should be met in nearly all cases. The document prioritizes indicators of broad clinical relevance, supported by evidence or expert consensus when data are lacking.<br /><br />Preprocedure indicators include ensuring procedures are performed for appropriate indications (target 95%), obtaining and documenting informed consent, conducting a focused history and physical examination, developing and documenting a sedation plan with risk assessment, administering prophylactic antibiotics only when indicated (98%), managing antithrombotic therapy through a formulated plan (95%), performing a team pause confirming patient identity and procedure, and ensuring procedures are done by credentialed practitioners (98%). These steps optimize safety and appropriateness, reduce harm, and respect patient autonomy.<br /><br />Intraprocedure indicators focus on photo documentation of anatomy and pathology (95%), patient monitoring during sedation (oxygen saturation, heart rate, blood pressure) with documentation (98%), documenting any sedation-related procedure interruptions or premature terminations (98%), and verifying specimen handling and labeling (98%). These measures promote procedural completeness, patient safety, and specimen integrity.<br /><br />Postprocedure indicators include documentation confirming patients have met discharge criteria (98%), providing clear patient instructions, communicating endoscopic findings, pathology, and follow-up plans to patients and providers (98%), creating comprehensive procedure reports (98%), documenting adverse events comprehensively (98%), and collecting patient satisfaction data. Accurate documentation and communication are essential for patient safety, care continuity, and quality assurance.<br /><br />Priority indicators emphasized for initial quality improvement focus are appropriate indication, prophylactic antibiotic use, antithrombotic therapy management, and adverse event documentation due to their impact and feasibility.<br /><br />Overall, this framework reiterates fundamental responsibilities such as patient consent, risk assessment, appropriate procedure use, careful sedation planning, and thorough documentation. Despite known compliance gaps, adherence to these indicators is critical to improving patient outcomes and delivering high-quality endoscopic care. The ASGE and ACG intend ongoing reassessment to refine these standards as clinical evidence evolves.

Meta Tag

Concept Endoscopy Quality Indicator

Concept Gastrointestinal Endoscopy

Concept Structural Measure

Concept Process Measures

Concept Outcome Quality Measure

Keywords

Gastrointestinal endoscopy

Quality indicators

Preprocedure assessment

Sedation management

Antibiotic prophylaxis

Antithrombotic therapy

Patient safety

Procedure documentation

Adverse event reporting

Patient consent

Endoscopy Quality Indicator

Gastrointestinal Endoscopy

Structural Measure

Process Measures

Outcome Quality Measure