Improving Quality and Safety in the Endoscopy Unit (Virtual) | October 2024-ASGE ACG QI for capsule endoscopy and deep enteroscopy

ASGE ACG QI for capsule endoscopy and deep enteroscopy

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The document outlines the development of quality indicators for capsule endoscopy (CE) and deep enteroscopy (DE), crucial medical procedures for diagnosing and treating small-bowel diseases. A task force of seven gastroenterologists used the RAND/UCLA Appropriateness Method to create a comprehensive set of quality indicators due to the absence of such guidelines, emphasizing improved patient care.<br /><br />The quality indicators were designed across three phases of the procedures: preprocedure, intraprocedure, and postprocedure. Twelve key indicators were highlighted for CE, including demonstrating competency in CE, ensuring informed consent, using tests for luminal patency before CE, and timely performance post-bleeding episodes. For DE, the panel identified eleven indicators, such as documenting competency, choosing the insertion route based on capsule selection, timely DE post-bleeding, and using carbon dioxide insufflation.<br /><br />The study emphasized the importance of developing systematic procedures, evaluating potential risks, and improving overall outcomes. For instance, capsule retention and adverse events in CE and DE are analyzed, stressing pre-emptive practices like evaluating contraindications and selecting patients based on thorough imaging or medical background.<br /><br />Gaps in knowledge were addressed, proposing future research questions to inform further guideline enhancement. Examples include exploring the ideal anticoagulation management for DE and optimal technologies for CE lesion localization. These efforts aim to standardize practices across medical settings, promoting efficiency and safety in diagnosing small-bowel conditions.<br /><br />This document represents a step forward in elevating the quality of care provided via CE and DE, filling existing voids with strategic, evidence-based protocols that can guide both current practices and future innovations in the field.

Keywords

quality indicators

capsule endoscopy

deep enteroscopy

small-bowel diseases

gastroenterologists

RAND/UCLA Appropriateness Method

patient care

systematic procedures

adverse events

guideline enhancement