Improving Quality in Upper Endoscopy

With more than 6.1 million EGDs performed in the United States annually, establishing quality measures is imperative. Having well-defined quality measures can ensure consistency for both providers and patients. These quality measures should also be evaluated and modified continually to determine what areas need improvement and to provide high-quality patient care. 

After review of previously prioritized quality measures, the Quality Assurance in Endoscopy Committee of the American Society for Gastrointestinal Endoscopy (ASGE) recently provided updated measures and established interventions that can improve performance of these measures. The committee determined relevant clinical questions and systematically reviewed literature pertaining to interventions and quality measures.

Following are the suggested interventions that may improve EGD quality indicators: 

• Document appropriate EGD indications in the procedural report for future audits and feedback, implement periodic audits of documented EGD indications, and create standardized electronic sets to improve compliance with appropriate indications. 
• Create standardized time-out sheets with a section for antibiotic use verification before endoscopy. 
• Consider implementing standardized order sets (action sets) in the protocolized management of upper GI bleeding. 
• Apply focused educational interventions to increase compliance with standardized Barrett’s esophagus examination protocols, which may improve clinical outcomes. 
• Utilize quality audits, dictation templates, and training programs to improve the optimal documentation of EGD reports.