Published online Nov 16, 2013. doi: 10.4253/wjge.v5.i11.574
Revised: August 10, 2013
Accepted: October 17, 2013
Published online: November 16, 2013
AIM: To perform a quality control (QC) review of endoscopic ultrasound (EUS) with emphasis on current consensus established quality indicators.
METHODS: A national quality control study of EUS was performed with expanded international comparison. Ten different healthcare institutions in Israel participated in coordination with University of Chicago Medical Center. Each Israeli center provided ten patient reports, compared with twenty reports from University of Chicago Medical Center. Quality indicator forms were prepared with sections to be completed before, during, and after EUS. Physician compliance to all listed indicators was evaluated. Quality indicators were evaluated prior to, during, and after performing EUS.
RESULTS: One hundred different EUS procedural reports were analyzed. The mean patient age was 59 years old. Indications for referral were mostly for pancreatic or biliary reasons. QC showed several strongly reported areas, including indications for EUS (97%), anesthesia given (94%), periprocedural pancreatic evaluation (87%), and an overall summary of the EUS examination (82%). Intermediately reported areas included patients’ pertinent past medical history (71.7%), evaluation of the biliary tree (63%), and providing medical guidance about potential procedural adverse events, including pancreatitis and bleeding (52%). Half of the reports (50%) did not include a systemic organ evaluation. Other areas, including systematic reporting of screened organs (36%), description of fine needle aspiration (15%), tumor description via tumor-node-metastasis (5%), and listing of adverse events (0%) were largely lacking from procedural documentation.
CONCLUSION: Documenting specific EUS quality indicators including listing post-procedural recommendations may improve the quality and efficiency of future EUS examinations and subsequent patient follow-up.
Core tip: Certain key points of quality control have been delineated as quality indicators by American and European Gastrointestinal Societies, which serve to establish and maintain high-quality gastrointestinal minimally invasive procedures and reports, minimize potential adverse events, and to optimize costs, resulting in savings for both hospitals and patients while optimizing patient care in the process. This national quality control study of endoscopic ultrasound (EUS) with expanded international comparison emphasized developing a standardized quality indicator table for EUS and subsequently evaluating physician adherence.