Quality indicators for EGD
Quality indicators for EGD
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DOI：
10.1016/j.gie.2014.07.057
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发表时间：
2015-01-01
影响因子：
7.7
通讯作者：
Wani, Sachin
中科院分区：
文献类型：
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作者：
Park, Walter G.;Shaheen, Nicholas J.;Wani, Sachin
61篇文学作品。如果没有数据支持建立绩效目标水平，则列出“N/A”（不可用）。然而，当专家一致认为未能执行给定的质量指标是“从不发生的事件”时，例如在镇静期间监测生命体征，则性能目标被列为> 98%。必须强调的是，所列业绩目标不一定反映护理标准，而是作为指导质量改进工作的具体目标。质量指标分为3个时间段：术前、术中和术后。对于每一类别，确定了关键的相关研究问题。为了指导持续的质量改进工作，工作队还根据其临床相关性和重要性，并根据临床实践中指标性能差异显著的证据，和测量的可行性（获得具有窄置信区间[CI]的准确测量所需的程序数量和测量的容易性的函数）。对于个别内镜医生来说，一种有用的方法是首先测量他们在这些优先指标方面的表现。如果内镜医师的表现高于推荐阈值，则质量改进工作将转向不同的质量指标，或者雇主和/或教学中心可以制定纠正措施并重新测量低水平表现者的表现。认识到某些质量指标对所有GI内镜手术都是通用的，这些项目在单独的文件中详细介绍，类似于2006年的过程（5）。所有内镜检查的术前、术中和术后常见指标见表2。这些共同因素将仅在本文件中讨论，只要讨论需要特别修改以与EGD相关。
61 literature when available. When data were unavailable to support establishing a performance target level,“N/A”(not available) was listed. However, when expert consensus considered failure to perform a given quality indicator a “never event,” such as monitoring vital signs during sedation, then the performance target was listed as> 98%. It is important to emphasize that the performance targets listed do not necessarily reflect the standard of care but rather serve as specific goals to direct quality improvement efforts. Quality indicators were divided into 3 time periods: pre-procedure, intraprocedure, and postprocedure. For each category, key relevant research questions were identified. In order to guide continuous quality improvement efforts, the task force also recommended a high-priority subset of the indicators described, based on their clinical relevance and importance, on evidence that performance of the indicator varies significantly in clinical practice, and feasibility of measurement (a function of the number of procedures needed to obtain an accurate measurement with narrow confidence intervals [CI] and the ease of measurement). A useful approach for individual endoscopists is to first measure their performances with regard to these priority indicators. Quality improvement efforts would then move to different quality indicators if endoscopists are performing above recommended thresholds, or the employer and/or teaching center could institute corrective measures and remeasure performance of low-level performers.Recognizing that certain quality indicators are common to all GI endoscopic procedures, such items are presented in detail in a separate document, similar to the process in 2006 (5). The preprocedure, intraprocedure, and postpro-cedure indicators common to all endoscopy are listed in Table 2. Those common factors will be discussed only in this document insofar as the discussion needs to be modified specifically to relate to EGD.