Improved patient care using the A/S/G/E guidelines on quality assurance: a prospective comparative study.
The American Society for Gastrointestinal Endoscopy has promulgated guidelines on quality assurance in gastrointestinal endoscopy. Thorough documentation of endoscopy reports and a peer review process were strongly recommended. We evaluated 1408 dictated endoscopy and colonoscopy reports for deficiency in reference to the guidelines during three periods: 6 months before (group 1), 6 months after the application of the guidelines (group 2), and 5 months of intensive peer review process (group 3). Deficiency was defined as lack of documentation of at least 1 of the 10 parameters that should be included in endoscopy reports according to the guidelines. There was a significant decrease in deficiency rates in groups 2 (91.6%) and 3 (32.7%) compared with group 1 (99.8%) (p less than 0.01). Peer review and direct confrontation of the endoscopists with their deficiencies significantly reduced the use of inappropriate indication for endoscopy (1.5%/group 3 vs. 5.2%/group 1, p less than 0.01). Adherence to the A/S/G/E guidelines on quality assurance improved documentation, decreased inappropriate use of endoscopy, and may thus improve quality of care.
Mai
H D
HD
Division of Gastroenterology, Carl T. Hayden Veterans Administration Medical Center, Phoenix, AZ 85012.
Sanowski
R A
RA
Waring
J P
JP
D002985:Clinical Protocols / Q000592:standards*; D004282:Documentation / Q000592:standards; D016099:Endoscopy, Gastrointestinal / Q000592:standards*; D005069:Evaluation Studies as Topic; D006801:Humans; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D011787:Quality of Health Care; D012955:Societies, Medical; D014481:United States