Improving Quality and Safety in the Endoscopy Unit (On-Demand) | August 2023-03_ASGE Quality_Yang

03_ASGE Quality_Yang_Adv Endoscopy

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In this document, Dr. Julie Yang discusses the quality indicators for advanced endoscopy and upper gastrointestinal (GI) bleeding. The author emphasizes the importance of high-quality procedures, which include appropriate indications, correct diagnoses, appropriate therapy, and minimal risk. The ratio between the incidence of correct performance and the opportunity for correct performance is used as a quality indicator.<br /><br />For ERCP (endoscopic retrograde cholangiopancreatography), the author provides several quality indicators such as successful cannulation, appropriate use of antibiotics, and fast procedure time. It is also noted that higher procedure success and lower adverse event rates are associated with higher volumes of ERCP performed.<br /><br />For EUS (endoscopic ultrasound), quality indicators include appropriate indications and low rates of adverse events such as perforation and bleeding. The author also highlights the importance of accurate cancer staging and high diagnostic rates for pancreatic masses.<br /><br />In terms of upper GI bleeding, quality indicators for EGD (esophagogastroduodenoscopy) include the performance of endoscopic treatment for bleeding ulcers and documentation of plans for testing for H. pylori infection. Prophylactic antibiotics and proton pump inhibitors are also recommended for patients with cirrhosis and suspected peptic ulcer bleeding.<br /><br />The document emphasizes the need for healthcare providers to maintain the highest level of quality and suggests reviewing the available quality documents to empower themselves. Additionally, meeting targets for priority indicators is crucial, and if targets are not being met, quality improvement initiatives can be implemented. The author mentions that there are recently released documents by the ASGE (American Society for Gastrointestinal Endoscopy) that provide interventions to improve quality indicators.

Keywords

quality indicators

advanced endoscopy

upper GI bleeding

ERCP

successful cannulation

adverse event rates

EUS

perforation

diagnostic rates

EGD