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

ASGE ACG QI for EUS 2015

Pdf Summary

The document discusses quality indicators for Gastrointestinal Endoscopic Ultrasound Procedures (EUS) as developed by the ASGE/ACG Task Force on Quality in Endoscopy. EUS is deemed essential for diagnosing and staging gastrointestinal and mediastinal mass lesions, assisting with procedures like Fine Needle Aspiration (EUS-FNA), and enabling core biopsies for molecular analysis. The effectiveness of EUS relies on proper application and adherence to quality indicators, which are categorized into structural, process, and outcome measures.<br /><br />Quality indicators are crucial in healthcare to assess and benchmark performance, aiming to enhance the quality of care. The document updates and expands upon indicators first proposed in 2006, integrating new data and focusing on indicators with wide-ranging clinical applicability and those validated in clinical studies.<br /><br />Indicators are classified based on different procedural phases: preprocedure, intraprocedure, and postprocedure. Preprocedure indicators involve ensuring appropriate indications, informed consent, risk assessment, management of medications, and procedural timeliness. Intraprocedure indicators emphasize documenting appearances of relevant structures and accurate cancer staging. Postprocedure indicators focus on documenting adverse events and ensuring effective communication and patient satisfaction.<br /><br />Research questions related to each phase aim to explore the impact of EUS on patient management and outcomes, the role of prophylactics, the adequacy of sample acquisition during EUS-FNA, and the training required for operators to achieve competency.<br /><br />Key priority indicators identified include the staging of GI cancers with recognized systems, diagnostic rates and sensitivities for pancreatic masses, and the incidence of adverse events post-EUS-FNA.<br /><br />The document emphasizes the need for hospitals to select the most relevant indicators for their settings while noting the potential for future updates as EUS technology and applications evolve. It underscores that while these indicators guide quality improvement, they are not exhaustive nor universally applicable across all practice settings. The ultimate goal is to ensure high-quality care for patients undergoing EUS procedures.

Keywords

Gastrointestinal Endoscopic Ultrasound

EUS quality indicators

ASGE/ACG Task Force

diagnosing mass lesions

Fine Needle Aspiration

core biopsies

structural measures

process measures

outcome measures

patient management