title: [Management of open access gastrointestinal endoscopy and quality of care: collaboration between an improvement team and primary care].
abstract: OBJECTIVE
  To create an improvement team within a healthcare quality improvement project of the Government of Aragon (Spain), aimed at increasing the quality of care and suitability of the indications of gastrointestinal endoscopy in the open access endoscopy system of a secondary hospital in Aragon.
  
  
  METHODS
  The team developed a consensus document indicating how to use oral endoscopy and colonoscopy correctly, and held information and training sessions with all the primary care physicians involved in this area.
  
  
  METHODS
  Sector I health centers and Royo Villanova Hospital, in Zaragoza.
  
  
  METHODS
  The team consisted of a gastroenterologist and three primary care physicians and, from the outset received the support of the primary care administration and management in the health area.
  
  
  RESULTS
  Inappropriate use of endoscopy, particularly colonoscopy, was reduced from 20% to 11.6%. Significant savings were achieved in health costs. The endoscopy waiting list was reduced. The quality of care and the safety of patients undergoing these examinations improved. Training of primary care physicians in these procedures was enhanced, and coordination between primary and specialized was implemented.
  
  
  CONCLUSIONS
  To ensure efficient running of an open access gastrointestinal endoscopy system, an interdisciplinary improvement team and the full involvement of the primary care staff managing this resource are required.
authors.affiliation: Unidad de Gestión Clínica de Aparato Digestivo, Hospital Royo Villanova, Zaragoza, España. jjsebastian@salud.aragon.es
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Sebastián Domingo
authors.forename: Clara
authors.initials: C
authors.lastname: Sánchez Sánchez
authors.forename: Eugenio
authors.initials: E
authors.lastname: Galve Royo
authors.forename: Carolina
authors.initials: C
authors.lastname: Mendi Metola
authors.forename: Javier
authors.initials: J
authors.lastname: Valdepérez Torrubia
mesh_terms: D032921:Consensus; D016099:Endoscopy, Gastrointestinal / Q000592:standards*; D006801:Humans; D017410:Practice Guidelines as Topic; D011320:Primary Health Care; D058996:Quality Improvement; D011787:Quality of Health Care