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

Video Transcription

Video Summary

The discussion covers challenges and strategies in colonoscopy quality metrics, surveillance intervals, autoimmune atrophic gastritis biopsies, and adverse event tracking. Key points include the critical importance of high-quality baseline colonoscopy for preventing interval cancers, as increasing colonoscopy frequency rarely reduces missed lesions. Adherence to surveillance guidelines is complicated by patient-provider communication and entrenched initial recommendations. For autoimmune gastritis, biopsy remains essential even if the stomach appears normal, focusing on identifying intestinal metaplasia subtypes. Measuring adenoma detection rate (ADR) is preferred over polyp detection rate (PDR) due to risk of gaming and irrelevant polyps. Implementing quality metrics is resource-intensive, but tools like GI QUIC registry and Epic systems can help automate processes. Reporting and tracking adverse events remain manual and underreported; combining electronic health records and patient follow-up calls may assist. For consent in combined procedures like EOS and ERCP, proactive integrated consent and procedural planning avoid ethical dilemmas when unexpected findings arise.

Asset Subtitle

Moderator: Jessica X. Yu, MD, MS

Keywords

colonoscopy quality metrics

surveillance intervals

autoimmune atrophic gastritis biopsies

adenoma detection rate

adverse event tracking

integrated consent procedures