Improving Quality and Safety in the Endoscopy Unit (On-Demand) | August 2023-ASGE Interventions to improve upper endoscopy

ASGE Interventions to improve upper endoscopy

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This document is a summary of a systematic review that aimed to identify interventions and measures that improve the performance of upper GI endoscopy quality indicators. Upper GI endoscopy is a common procedure used for diagnostic and therapeutic purposes. The quality indicators for upper GI endoscopy have been well-established, but there is limited data on interventions to improve them.<br /><br />The review found that interventions such as audits and feedback, educational programs, implementation of standardized order sets, and the use of standardized documentation can improve compliance with appropriate indications when requesting an endoscopy. However, strong evidence is lacking for interventions that improve compliance with preprocedural prophylactic antibiotics administration and important preprocedural therapies in upper GI bleeding.<br /><br />For preprocedural measures in Barrett's esophagus screening/surveillance endoscopy, focused educational interventions and training tools have been shown to improve the recognition and detection of neoplastic lesions.<br /><br />In terms of intraprocedural quality indicators, interventions such as quality audits, the use of dictation templates, and training programs can improve the documentation of a complete or incomplete examination. However, there is limited evidence on interventions to improve compliance with sampling in gastric pathology, the identification of high-risk endoscopic stigmata in bleeding peptic ulcer disease, and intraprocedural quality measures in bleeding variceal disease.<br /><br />For postprocedural quality indicators, interventions such as standardized documentation and providing patients with their endoscopy report and plan of care can improve initiation of therapies, surveillance endoscopy recall, and overall compliance with care.<br /><br />Overall, this review highlights the need for further research to assess interventions that can improve important quality indicators in upper GI endoscopy. It also emphasizes the importance of tracking and monitoring performance indicators and providing feedback and evidence-based interventions to improve the quality of endoscopy procedures.

Keywords

upper GI endoscopy

quality indicators

interventions

audits and feedback

educational programs

standardized order sets

standardized documentation

Barrett's esophagus screening/surveillance endoscopy

intraprocedural quality indicators

postprocedural quality indicators