Improving Quality and Safety in the Endoscopy Unit (On-Demand) | October 2024-ASGE_quality measures

ASGE_quality measures_equitable care

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The American Society for Gastrointestinal Endoscopy (ASGE) has highlighted disparities in endoscopic care for traditionally underserved patients in the United States through a white paper that proposes quality measures to alleviate these inequities. The document, crafted by the ASGE Quality Assurance in Endoscopy Committee, acknowledges the variability in care quality due to factors like race, socioeconomic status, and geographic location affecting underserved communities. It aims to guide endoscopists toward equitable and high-quality care by introducing a set of preliminary quality measures.<br /><br />These quality measures, not intended as minimum standards but as an initial framework for improvement, are categorized into three groups: structural, process, and patient-directed measures. Structural measures focus on up-to-date equipment and facilities catering to patient comfort, privacy, and dignity. Proposals include affording equal staffing standards across all practices and ensuring facilities are well-equipped, irrespective of the patient population served. Process measures emphasize diverse and inclusive staffing, coupled with necessary training in cultural competency and bias. The paper underscores the importance of creating a culturally informed approach to patient education and communication, recognizing the unique barriers faced by underserved groups.<br /><br />Priority measures recommended for initial focus include ensuring endoscopy units are well-equipped, providing sensitivity training for employees, and establishing effective communication infrastructure for non-English speaking patients. Additionally, financial support mechanisms should be developed to mitigate the costs borne by disadvantaged patients undergoing endoscopic procedures. The paper advocates for the participation of endoscopy units in philanthropic programs offering pro bono services to marginalized patients.<br /><br />The committee anticipates that these recommended measures will eventually become standard practices in endoscopic care, akin to existing quality benchmarks. By sharing experiences, stakeholders can devise a more strategic framework for successful implementation and continuously evolve these metrics to foster improvement and equity in endoscopic healthcare.

Keywords

ASGE

endoscopic care

health disparities

quality measures

underserved patients

cultural competency

structural measures

process measures

patient-directed measures

equitable healthcare