Subscribe to RSS
DOI: 10.1055/s-0042-100186
Requirements and standards facilitating quality improvement for reporting systems in gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement
Publication History
Publication Date:
03 February 2016 (online)
To develop standards for high quality in gastrointestinal (GI) endoscopy, the European Society of Gastrointestinal Endoscopy (ESGE) has established the ESGE Quality Improvement Committee. A prerequisite for quality assurance and improvement for all GI endoscopy procedures is state-of-the-art integrated digital reporting systems for standardized documentation of the procedures. The current paper describes the ESGE’s viewpoints on the requirements for high-quality endoscopy reporting systems in GI endoscopy.
Recommendations
1 Endoscopy reporting systems must be electronic.
2 Endoscopy reporting systems should be integrated into hospitals’ patient record systems.
3 Endoscopy reporting systems should include patient identifiers to facilitate data linkage to other data sources.
4 Endoscopy reporting systems shall restrict the use of free-text entry to a minimum, and be based mainly on structured data entry.
5 Separate entry of data for quality or research purposes is discouraged. Automatic data transfer for quality and research purposes must be facilitated.
6 Double entry of data by the endoscopist or associate personnel is discouraged. Available data from outside sources (administrative or medical) must be made available automatically.
7 Endoscopy reporting systems shall facilitate the inclusion of information on histopathology of detected lesions, patient satisfaction, adverse events, and surveillance recommendations.
8 Endoscopy reporting systems must facilitate easy data retrieval at any time in a universally compatible format.
9 Endoscopy reporting systems must include data fields for key performance indicators as defined by quality improvement committees.
10 Endoscopy reporting systems must facilitate changes in indicators and data entry fields as required by professional organizations.
-
References
- 1 Groenen MJ, Hirs W, Becker H et al. Gastrointestinal endoscopic terminology coding (GET-C): a WHO-approved extension of the ICD-10. Dig Dis Sci 2007; 52: 1004-1008
- 2 Delvaux M, Crespi M, Armengol-Miro JR et al. Minimal standard terminology for digestive endoscopy: results of prospective testing and validation in the GASTER project. Endoscopy 2000; 32: 345-355
- 3 Aabakken L, Rembacken B, LeMoine O et al. Minimal standard terminology for gastrointestinal endoscopy – MST 3.0. Endoscopy 2009; 41: 727-728
- 4 Aabakken L, Barkun AN, Cotton PB et al. Standardized endoscopic reporting. J Gastroenterol Hepatol 2014; 29: 234-240
- 5 van Doorn SC, van Vliet J, Fockens P et al. A novel colonoscopy reporting system enabling quality assurance. Endoscopy 2014; 46: 181-187
- 6 Groenen MJ, Ajodhia S, Wynstra JY et al. A cost-benefit analysis of endoscopy reporting methods: handwritten, dictated and computerized. Endoscopy 2009; 41: 603-609
- 7 Moorman PW, van Ginneken AM, van der Lei J et al. The contents of free-text endoscopy reports: an inventory and evaluation by peers. Endoscopy 1994; 26: 531-538
- 8 de Lange T, Moum BA, Tholfsen JK et al. Standardization and quality of endoscopy text reports in ulcerative colitis. Endoscopy 2003; 35: 835-840
- 9 Aabakken L. Quality reporting – finally achievable?. Endoscopy 2014; 46: 188-189
- 10 Hoff G, Ottestad PM, Skafløtten SR et al. Quality assurance as an integrated part of the electronic medical record – a prototype applied for colonoscopy. Scand J Gastroenterol 2009; 44: 1259-1265
- 11 Lieberman D, Nadel M, Smith RA et al. Standardized colonoscopy reporting and data system: report of the Quality Assurance Task Group of the National Colorectal Cancer Roundtable. Gastrointest Endosc 2007; 65: 757-766
- 12 Gotfried J, Bernstein M, Ehrlich AC et al. Administrative database research overestimates the rate of interval colon cancer. J Clin Gastroenterol 2015; 49: 483-490