Overcoming the barriers to dissemination and implementation of quality measures for gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology (UEG) position statement

Abstract

The European Society of Gastrointestinal Endoscopy (ESGE) has developed performance measures and established a framework for quality assessment for gastrointestinal endoscopy in Europe. Most national societies actively undertake initiatives to implement and explicitly endorse these quality indicators. Given this, ESGE proposes that, at a national level, strong leadership should exist to disseminate and implement quality parameters. Thus, understanding the potential barriers that may vary locally is of paramount importance. ESGE suggests that each national society should prioritize quality and standards of care in gastrointestinal endoscopy in their activities and should survey/understand which measures are a local priority to their members and make measuring quality intrinsic to daily endoscopy practice.

The use of Faecal Microbiota Transplantation (FMT) in Europe: A Europe-wide survey

“…As a next step in the continuous harmonisation of FMT in Europe, the present survey points to the need for shared, consensus-based definitions of operational metrics for measuring and comparing FMT centres and later stool banks. These could be similar to those used in endoscopy centres [26] and should (i) help indicate the FMT centre's current level of development, (ii) endorse quality measures for auditing, (iii) facilitate improvement, and (iv) assist in identifying current barriers to dissemination. For FMT, these metrics could include measurable performance indicators such as donor deferral rates, number of released, ready-to-use FMT preparations, number of procedures for certain indications, waste of preparations, as well as quality indicators such as adherence to the international standards for donor screening and laboratory handling or the level of implementation of e.g., stool bank capacity.…”

Implementation of quality measures in endoscopy: Catch them young!

“…And although the papers explain the clinical relevance of the proposed measures and possible benefits for patient care, implementation of the performance measures is not self‐evident. Therefore, the latest publication of the ESGE QIC is aimed at identifying barriers that may prevent acceptance and implementation of their proposed quality performance measures, and to suggest interventions to overcome these barriers 7 …”

ESGE quality parameters in colonoscopy: How to ensure their adoption?

“…The latter initiative nicely illustrates how dissemination and adoption of quality parameters can be facilitated by national initiatives. Indeed, in real practice, many barriers to implementation of PMs can be identified [11]. Resistance to change is certainly one of them, maybe because the reality of the problem is not well perceived.…”

“…In addition, there are practical considerations, such as electronic reporting systems that are lacking or do not enable automatic auditing of PMs [11]. Although this challenge can be solved, as with the British National Endoscopy Database [12] or the Dutch one [13], this possibility is far from reality in many countries or centers.…”

“…Start measuring quality in your own unit now! ESGE has developed the ESGE quality check app (quality@esge.com) and measuring approximately 300 gastroscopies and 300 colonoscopies per audit would allow for an adequate snapshot of the quality of those procedures in your unit [11].…”