Improving Quality and Safety in the Endoscopy Unit (On-demand) | November 2025-Leveraging the IOM Domains of Quality in Decision-making

Video Transcription

Video Summary

This talk discusses leveraging the Institute of Medicine (IOM) domains of quality—safe, effective, efficient, patient-centered, timely, equitable, and sustainable—in medical decision-making, particularly in endoscopy. The speaker traces the history of quality definitions in medicine, highlighting key milestones like Donabedian’s 1966 framework and the IOM’s 1999 and 2001 landmark reports. Emphasizing the interdependence of the domains, examples illustrate how decisions impact various quality aspects, such as BMI-based site restrictions, using phenethylamine in flush water, and honoring patient gender preferences for endoscopists. The talk stresses balancing these domains when making changes. It introduces models for measuring and improving quality, including Donabedian’s structure-process-outcome framework and the Plan-Do-Study-Act and Lean Six Sigma cycles. The speaker advocates forming dedicated quality improvement teams in endoscopy units, underscores the importance of defining quality metrics, and concludes that using these domains and quality improvement tools can effectively enhance healthcare services.

Asset Subtitle

Sonali Palchaudhuri, MD, MHCI

Keywords

Institute of Medicine quality domains

medical decision-making in endoscopy

Donabedian quality framework

quality improvement models

patient-centered care

Lean Six Sigma in healthcare