Improving Quality and Safety in the Endoscopy Unit (On-Demand)

07_Shahidi_EGD

Pdf Summary

The document by Neal Shahidi, MD, focuses on defining and measuring quality in upper gastrointestinal (GI) endoscopy, specifically esophagogastroduodenoscopy (EGD). EGD is a common procedure, with approximately 7.5 million performed in the U.S. in 2019. Despite its frequency, EGDs can sometimes be perceived as quick and routine, potentially undermining the complexity and importance of delivering high-quality procedures.<br /><br />High-quality EGD is characterized by several factors: the procedure should have a clear medical indication, relevant diagnoses must be effectively established or excluded, any provided therapy should be appropriate and effective, and potential harm to the patient must be minimized. These factors aim to ensure the procedure's efficacy and safety for patients.<br /><br />The document also notes a problem with EGD procedures being performed without appropriate indications, with studies showing this happens in 5%-49% of cases. This highlights a significant area for improvement in clinical practice to avoid unnecessary procedures.<br /><br />During the intra-procedure phase, several key conditions are addressed, including gastroesophageal reflux disease (GERD), eosinophilic esophagitis (EoE), Barrett’s esophagus, upper GI bleeding, gastric cancer prevention, and celiac disease. The techniques, care, and considerations specific to these conditions are critical for optimizing procedural outcomes and preventing malignancies or other complications.<br /><br />The post-procedure phase, not detailed in the document, would likely involve patient monitoring, management of any adverse effects, and ensuring that the intervention's goals—whether diagnostic or therapeutic—have been successfully met.<br /><br />Overall, this document underscores the importance of maintaining high standards in EGD procedures by emphasizing appropriate indications and comprehensive care to enhance diagnostic yield and therapeutic benefits while minimizing risks.

Keywords

upper gastrointestinal endoscopy

esophagogastroduodenoscopy

EGD quality

medical indication

diagnostic yield

therapeutic benefits

unnecessary procedures

GERD

Barrett's esophagus

gastric cancer prevention