Improving Quality and Safety in the Endoscopy Unit (Virtual) | October 2024-Interactive Case Discussion 2

Video Transcription

Video Summary

The discussion revolved around best practices and challenges in colonoscopy and endoscopy, focusing on adenoma detection rates (ADR), surveillance intervals, and patient communication. T.R. addressed the complexities of calculating ADR, especially in cases involving poor preps often related to inpatient procedures. It was suggested to exclude inpatient cases from ADR calculations, as outpatient benchmarks are more applicable. Regarding surveillance intervals following polyp removal, T.R. emphasized waiting for pathology results before assigning intervals, although logistical challenges in electronic records can complicate follow-ups.<br /><br />Alternative strategies, such as the resect and discard method for adenomas appearing benign, were briefly touched upon, noting slow adoption due to reassurance provided by pathology. Discussions on patient-centered care suggested aligning communication with what primary care providers access in medical records for seamless continuity of care.<br /><br />The conversation also explored the role of advanced techniques like distal caps in improving ADR and the diminishing returns of very high ADR percentages. Finally, discussions around surveillance for older patients highlighted the need for individual assessments based on patient age and comorbidities, suggesting surveillance cessation for low-risk patients over 75, while those with advanced adenomas may require continued monitoring up to age 85.

Asset Subtitle

Moderator: Sonali Palchaudhuri, MD MHCI

Keywords

colonoscopy

adenoma detection rates

surveillance intervals

patient communication

advanced techniques

pathology

patient-centered care