Improving Quality and Safety in the Endoscopy Unit (Virtual) | August 2023-03_ASGE Quality_Yang

03_ASGE Quality_Yang_Adv Endoscopy

Pdf Summary

This document discusses quality indicators for advanced endoscopy procedures, specifically ERCP (Endoscopic Retrograde Cholangiopancreatography), EUS (Endoscopic Ultrasound), and upper gastrointestinal bleeding. The background emphasizes the importance of high-quality procedures, which include appropriate indication, correct diagnoses, and minimized risk. Quality indicators are defined as the ratio between the incidence of correct performance and the opportunity for correct performance.<br /><br />The section on ERCP quality indicators lists various measures, such as successful cannulation, appropriate stone extraction, and informed consent. The volume-outcomes relationship is also highlighted, showing that higher volume endoscopists and centers have higher procedure success rates and fewer adverse events. The document mentions that a large percentage of providers perform less than 50 ERCPs per year, and only 5% of hospitals perform over 200 ERCPs per year.<br /><br />For EUS quality indicators, the document mentions the appropriate indications and adverse events associated with EUS-guided procedures. Priority quality indicators for EUS include staging cancers with the TNM staging system, diagnostic rates for cancer in pancreatic masses, and rates of adverse events.<br /><br />In the section on upper gastrointestinal bleeding, quality indicators for EGD (Esophagogastroduodenoscopy) are listed, such as performing endoscopic treatment for bleeding ulcers and documenting plans to test for Helicobacter pylori infection.<br /><br />Overall, the document emphasizes the importance of maintaining high-quality procedures and provides specific quality indicators for different advanced endoscopy procedures. It encourages healthcare providers to review the quality documents and focus on meeting targets for priority indicators. If targets are not being met, they can be the focus of quality improvement initiatives. Recently released documents by ASGE (American Society for Gastrointestinal Endoscopy) are mentioned, which provide interventions to improve quality indicators.

Keywords

quality indicators

advanced endoscopy procedures

ERCP

EUS

upper gastrointestinal bleeding

volume-outcomes relationship

adverse events

healthcare providers

priority indicators

ASGE