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

08_Pannala_ERCP_EUS

Pdf Summary

The document "Defining and Measuring Quality in ERCP and EUS" by Dr. Rahul Pannala details quality metrics and strategies for ensuring high-quality practices in Endoscopic Retrograde Cholangiopancreatography (ERCP) and Endoscopic Ultrasound (EUS). Key focus areas include setting clear indications, ensuring proper patient selection, assembling a skilled team, and using appropriate tools and protocols.<br /><br />High-quality ERCP and EUS procedures require a systematic approach that includes thorough informed consent, considering each patient’s specific risks and alternatives, and emphasizing effective communication within the medical team and with the patient and their family. Specific quality measures for ERCP involve detailed knowledge of tool utilization, wire-guided atraumatic cannulation, administration of rectal NSAIDs, and the use of prophylactic pancreatic stents.<br /><br />For EUS procedures, pre-procedure and intraprocedure quality indicators focus on using the appropriate diagnostic techniques, such as core biopsy needles for solid masses, and on closely monitoring patient outcomes to minimize adverse events. Feedback loops and continuous evaluation of procedures and outcomes are emphasized as means to optimize both patient and procedural factors.<br /><br />In summary, achieving high-quality outcomes in ERCP and EUS requires a team with the necessary skill sets, a focus on both cognitive and technical aspects, and consistent use of tools and methodologies suited to the complexity of each procedure. The document encourages establishing a culture of quality and safety, driving improvements through the measurement of quality metrics, and promoting a collaborative, team-based approach to therapeutic endoscopy.

Keywords

ERCP

EUS

quality metrics

patient selection

informed consent

cannulation

NSAIDs

prophylactic stents

diagnostic techniques

procedure evaluation