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Quality improvement gastroenterology

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https://www.readbyqxmd.com/read/28545503/time-to-endoscopic-intervention-in-patients-with-upper-gastrointestinal-patients-can-be-improved-with-pathway-provision
#1
R Singer, P Campbell, C Fernandes, P Statham, D Hochhauser, J Bridgewater
BACKGROUND: Patients with upper gastrointestinal malignancy often require admission to hospital with dysphagia or jaundice requiring therapeutic endoscopy. Endoscopic intervention is often effective permitting rapid discharge. An efficient service would permit rapid discharge for patients who are often at the end of life. We noted that a majority of patients in hospital under the gastroenterological oncology were admitted with symptoms requiring therapeutic endoscopy. METHODS: We conducted an audit cycle of the inpatient days before and after pathway implementation...
May 25, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28511169/efficiency-comparison-of-tofacitinib-and-budesonid-in-treatment-of-nonspecific-ulcerative-colitis
#2
Andriy M Bratasiuk, Antonina I Niroda
INTRODUCTION: A constant interest to explore NUC is caused by the global trend showing a rise in colitis mobidity rate. According to a series of epidemiological studies, the highest incidence of NUC occurs in young age groups, which leads to significant loss of working capacity and high level of incapacitation. One of the leading roles in the pathogenesis of this disease is reportedly played by immunogenetic theory. To date, the main practical technique of NUC diagnostics is colonoscopy...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28509817/modified-delphi-process-for-the-development-of-choosing-wisely-for-inflammatory-bowel-disease
#3
Geoffrey C Nguyen, Karen Boland, Waqqas Afif, Brian Bressler, Jennifer L Jones, Adam V Weizman, Sharyle Fowler, Smita Halder, Vivian W Huang, Gilaad G Kaplan, Reena Khanna, Sanjay K Murthy, Joannie Ruel, Cynthia H Seow, Laura E Targownik, Tanya Chawla, Luis Guimaraes, Aida Fernandes, Sherif Saleh, Gil Y Melmed
BACKGROUND AND AIMS: The prevalence and incidence of inflammatory bowel disease (IBD) in North America is among the highest in the world and imparts substantial direct and indirect medical costs. The Choosing Wisely Campaign was launched in wide variety of medical specialties and disciplines to reduce unnecessary or harmful tests or treatment interventions. METHODS: The Choosing Wisely list for IBD was developed by the Canadian IBD Network for Research and Growth in Quality Improvement (CINERGI) in collaboration with Crohn's and Colitis Canada (CCC) and the Canadian Association of Gastroenterology (CAG)...
June 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28509768/modified-delphi-process-for-the-development-of-choosing-wisely-for-inflammatory-bowel-disease
#4
Geoffrey C Nguyen, Karen Boland, Waqqas Afif, Brian Bressler, Jennifer L Jones, Adam V Weizman, Sharyle Fowler, Smita Halder, Vivian W Huang, Gilaad G Kaplan, Reena Khanna, Sanjay K Murthy, Joannie Ruel, Cynthia H Seow, Laura E Targownik, Tanya Chawla, Luis Guimaraes, Aida Fernandes, Sherif Saleh, Gil Y Melmed
BACKGROUND AND AIMS: The prevalence and incidence of inflammatory bowel disease (IBD) in North America is among the highest in the world and imparts substantial direct and indirect medical costs. The Choosing Wisely Campaign was launched in wide variety of medical specialties and disciplines to reduce unnecessary or harmful tests or treatment interventions. METHODS: The Choosing Wisely list for IBD was developed by the Canadian IBD Network for Research and Growth in Quality Improvement (CINERGI) in collaboration with Crohn's and Colitis Canada (CCC) and the Canadian Association of Gastroenterology (CAG)...
May 15, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28507745/performance-measures-for-lower-gastrointestinal-endoscopy-a-european-society-of-gastrointestinal-endoscopy-esge-quality-improvement-initiative
#5
REVIEW
Michal F Kaminski, Siwan Thomas-Gibson, Marek Bugajski, Michael Bretthauer, Colin J Rees, Evelien Dekker, Geir Hoff, Rodrigo Jover, Stepan Suchanek, Monika Ferlitsch, John Anderson, Thomas Roesch, Rolf Hultcranz, Istvan Racz, Ernst J Kuipers, Kjetil Garborg, James E East, Maciej Rupinski, Birgitte Seip, Cathy Bennett, Carlo Senore, Silvia Minozzi, Raf Bisschops, Dirk Domagk, Roland Valori, Cristiano Spada, Cesare Hassan, Mario Dinis-Ribeiro, Matthew D Rutter
The European Society of Gastrointestinal Endoscopy and United European Gastroenterology present a short list of key performance measures for lower gastrointestinal endoscopy. We recommend that endoscopy services across Europe adopt the following seven key performance measures for lower gastrointestinal endoscopy for measurement and evaluation in daily practice at a center and endoscopist level: 1 rate of adequate bowel preparation (minimum standard 90%); 2 cecal intubation rate (minimum standard 90%); 3 adenoma detection rate (minimum standard 25%); 4 appropriate polypectomy technique (minimum standard 80%); 5 complication rate (minimum standard not set); 6 patient experience (minimum standard not set); 7 appropriate post-polypectomy surveillance recommendations (minimum standard not set)...
April 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28417650/assessment-potential-of-a-new-suture-simulator-in-laparoscopic-surgical-skills-training
#6
Tomohira Takeoka, Shuji Takiguchi, Munenori Uemura, Yasuhiro Miyazaki, Tsuyoshi Takahashi, Yukinori Kurokawa, Tomoki Makino, Makoto Yamasaki, Masaki Mori, And Yuichiro Doki
BACKGROUND: The skills necessary for performing effective laparoscopic suturing are difficult to acquire; as a result, simulators for learning these skills are rapidly becoming integrated into surgical training. The aim of the study was to verify whether a new hybrid simulator has the potential to measure skill improvement in young, less experienced gastroenterological surgeons. MATERIAL AND METHODS: The study included 12 surgeons (median age, 29 (27-38)] years; 11 men (91...
April 18, 2017: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/28344786/united-european-gastroenterology-evidence-based-guidelines-for-the-diagnosis-and-therapy-of-chronic-pancreatitis-hapaneu
#7
REVIEW
J Matthias Löhr, Enrique Dominguez-Munoz, Jonas Rosendahl, Marc Besselink, Julia Mayerle, Markus M Lerch, Stephan Haas, Fatih Akisik, Nikolaos Kartalis, Julio Iglesias-Garcia, Jutta Keller, Marja Boermeester, Jens Werner, Jean-Marc Dumonceau, Paul Fockens, Asbjorn Drewes, Gürlap Ceyhan, Björn Lindkvist, Joost Drenth, Nils Ewald, Philip Hardt, Enrique de Madaria, Heiko Witt, Alexander Schneider, Riccardo Manfredi, Frøkjer J Brøndum, Sasa Rudolf, Thomas Bollen, Marco Bruno
BACKGROUND: There have been substantial improvements in the management of chronic pancreatitis, leading to the publication of several national guidelines during recent years. In collaboration with United European Gastroenterology, the working group on 'Harmonizing diagnosis and treatment of chronic pancreatitis across Europe' (HaPanEU) developed these European guidelines using an evidence-based approach. METHODS: Twelve multidisciplinary review groups performed systematic literature reviews to answer 101 predefined clinical questions...
March 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28334433/dietary-interventions-for-recurrent-abdominal-pain-in-childhood
#8
REVIEW
Tamsin V Newlove-Delgado, Alice E Martin, Rebecca A Abbott, Alison Bethel, Joanna Thompson-Coon, Rebecca Whear, Stuart Logan
BACKGROUND: This is an update of the original Cochrane review, last published in 2009 (Huertas-Ceballos 2009). Recurrent abdominal pain (RAP), including children with irritable bowel syndrome, is a common problem affecting between 4% and 25% of school-aged children. For the majority of such children, no organic cause for their pain can be found on physical examination or investigation. Many dietary inventions have been suggested to improve the symptoms of RAP. These may involve either excluding ingredients from the diet or adding supplements such as fibre or probiotics...
March 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28268235/performance-measures-for-lower-gastrointestinal-endoscopy-a-european-society-of-gastrointestinal-endoscopy-esge-quality-improvement-initiative
#9
Michal F Kaminski, Siwan Thomas-Gibson, Marek Bugajski, Michael Bretthauer, Colin J Rees, Evelien Dekker, Geir Hoff, Rodrigo Jover, Stepan Suchanek, Monika Ferlitsch, John Anderson, Thomas Roesch, Rolf Hultcranz, Istvan Racz, Ernst J Kuipers, Kjetil Garborg, James E East, Maciej Rupinski, Birgitte Seip, Cathy Bennett, Carlo Senore, Silvia Minozzi, Raf Bisschops, Dirk Domagk, Roland Valori, Cristiano Spada, Cesare Hassan, Mario Dinis-Ribeiro, Matthew D Rutter
The European Society of Gastrointestinal Endoscopy and United European Gastroenterology present a short list of key performance measures for lower gastrointestinal endoscopy. We recommend that endoscopy services across Europe adopt the following seven key performance measures for lower gastrointestinal endoscopy for measurement and evaluation in daily practice at a center and endoscopist level: 1 Rate of adequate bowel preparation (minimum standard 90 %); 2 Cecal intubation rate (minimum standard 90 %); 3 Adenoma detection rate (minimum standard 25 %); 4 Appropriate polypectomy technique (minimum standard 80 %); 5 Complication rate (minimum standard not set); 6 Patient experience (minimum standard not set); 7 Appropriate post-polypectomy surveillance recommendations (minimum standard not set)...
April 2017: Endoscopy
https://www.readbyqxmd.com/read/28249809/suboptimal-implementation-of-evidence-based-therapy-for-acute-variceal-hemorrhage-a-systematic-review-of-observational-studies
#10
REVIEW
Elliot B Tapper, Lauren Beste, Michael Curry, Alan Bonder, Akbar Waljee, Sameer Saini
BACKGROUND & AIMS: Gastroenterologists should strive to improve the outcomes associated with acute variceal hemorrhage (AVH) by optimizing care delivery and clinician preparedness through training. Unfortunately, data regarding contemporary outcomes and management of AVH are limited. METHODS: We performed a systematic review of cohort studies examining outcomes and management of AVH from January 1990 to September 2016. We pooled data on mortality and utilization of medical therapy, endoscopic interventions, balloon tamponade (BT), and salvage procedures (portal decompressive surgery or transjugular portosystemic shunt)...
February 27, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28228488/uk-guideline-on-transition-of-adolescent-and-young-persons-with-chronic-digestive-diseases-from-paediatric-to-adult-care
#11
Alenka J Brooks, Philip J Smith, Richard Cohen, Paul Collins, Andrew Douds, Valda Forbes, Daniel R Gaya, Brian T Johnston, Patrick J McKiernan, Charles D Murray, Shaji Sebastian, Monica Smith, Lisa Whitley, Lesley Williams, Richard K Russell, Sara A McCartney, James O Lindsay
The risks of poor transition include delayed and inappropriate transfer that can result in disengagement with healthcare. Structured transition care can improve control of chronic digestive diseases and long-term health-related outcomes. These are the first nationally developed guidelines on the transition of adolescent and young persons (AYP) with chronic digestive diseases from paediatric to adult care. They were commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology under the auspices of the Adolescent and Young Persons (A&YP) Section...
June 2017: Gut
https://www.readbyqxmd.com/read/28192101/transforming-gastroenterology-care-with-telemedicine
#12
REVIEW
Corey A Siegel
Health care is changing rapidly, so we must change with the times to develop more efficient, practical, cost-effective, and, importantly, high-quality methods to care for patients. We teach medical students that optimal patient care requires face-to-face interaction to collect information on the patient's history and perform the physical examination. However, management of many patients-especially those with chronic diseases-does not always require physical examination. Telemedicine offers an opportunity to take advantage of technology while leveraging the progressive push toward efficiency and value but also requires the belief that excellent patient care is not always provided in person...
April 2017: Gastroenterology
https://www.readbyqxmd.com/read/28179979/flexible-gastro-intestinal-endoscopy-clinical-challenges-and-technical-achievements
#13
REVIEW
Niehls Kurniawan, Martin Keuchel
Flexible gastro-intestinal (GI) endoscopy is an integral diagnostic and therapeutic tool in clinical gastroenterology. High quality standards for safety, patients' comfort, and efficiency have already been achieved. Clinical challenges and technical approaches are discussed in this short review. Image enhanced endoscopy for further characterization of mucosal and vascular patterns includes dye-spray or virtual chromoendoscopy. For confocal laser endoscopy, endocytoscopy, and autofluorescence clinical value has not yet been finally evaluated...
2017: Computational and Structural Biotechnology Journal
https://www.readbyqxmd.com/read/28139500/variation-in-inflammatory-bowel-disease-care-among-saudi-pediatric-gastroenterologists
#14
Ahmed A Al-Sarkhy
BACKGROUND/AIM: Although international guidelines in inflammatory bowel disease (IBD) management are currently available, variations in IBD care still exist. The aim of this study was to determine the extent of the variation in IBD care among Saudi pediatric gastroenterologists. MATERIALS AND METHODS: A cross-sectional survey was conducted among all pediatric gastroenterologists who were members of the Saudi Society of Pediatric Gastroenterology, Hepatology, and Nutrition (SASPGHAN) from August 2015 to December 2015...
January 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28134689/the-care-of-the-colorectal-cancer-survivor
#15
Andrea Cercek, Peter R Holt
PURPOSE OF REVIEW: The gastroenterology literature emphasizes factors that increase colorectal cancer (CRC) incidence but presents little about management after initial CRC treatments. The purpose of this review is to describe the remarkably increasing numbers of CRC survivors in whom surveillance guidelines are often not followed and patient care is fragmented. The gastroenterologist can play an important role in this care to improve prognosis and overall health. RECENT FINDINGS: Existing surveillance recommendations by specialty societies for CRC survivors are fairly consistent but implementation occurs in less than half...
January 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28078798/systematic-review-with-meta-analysis-rifaximin-is-effective-and-safe-for-the-treatment-of-small-intestine-bacterial-overgrowth
#16
REVIEW
L Gatta, C Scarpignato
BACKGROUND: Small intestinal bacterial overgrowth (SIBO) is a heterogeneous syndrome, characterised by an increased number and/or abnormal type of bacteria in the small bowel. Over the past decades, rifaximin has gained popularity for this indication despite its use is not evidence based. AIM: To perform a systematic review and meta-analysis to summarise evidence about the efficacy and safety of rifaximin to eradicate SIBO in adult patients. METHODS: MEDLINE, EMBASE, CCRCT, Scopus and Web of Science were searched from inception to March 16, 2015 for RCTs and observational studies...
March 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28069744/coeliac-disease-screening-is-suboptimal-in-a-tertiary-gastroenterology-setting
#17
Heba Iskandar, Darrell M Gray, Hongha Vu, Faiz Mirza, Mary Katherine Rude, Kara Regan, Adil Abdalla, Srinivas Gaddam, Sami Almaskeen, Michael Mello, Evelyn Marquez, Claire Meyer, Ahmed Bolkhir, Navya Kanuri, Gregory Sayuk, C Prakash Gyawali
BACKGROUND AND AIMS: Coeliac disease (CD) is widely prevalent in North America, but case-finding techniques currently used may not be adequate for patient identification. We aimed to determine the adequacy of CD screening in an academic gastroenterology (GI) practice. METHODS: Consecutive initial visits to a tertiary academic GI practice were surveyed over a 3-month period as a fellow-initiated quality improvement project. All electronic records were reviewed to look for indications for CD screening according to published guidelines...
January 9, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28029300/hospice-utilization-and-its-effect-on-acute-care-needs-at-the-end-of-life-in-medicare-beneficiaries-with-hepatocellular-carcinoma
#18
Hanna K Sanoff, YunKyung Chang, Melissa Reimers, Jennifer L Lund
INTRODUCTION: Hepatocellular carcinoma (HCC) is a poor-prognosis cancer with a high symptom burden. Multidisciplinary HCC care is complex and unique in cancer medicine. We sought to determine whether the distinct process affects hospice use and how hospice affects end-of-life acute care utilization. PATIENTS AND METHODS: Patients dying after HCC diagnosed from 2004 to 2011 were identified within SEER-Medicare. Hospice use and associated factors were described using logistic regression...
March 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/27984349/creatively-improving-care-delivery
#19
Brendan M Boyle, Ivor Hill
The medical community has been challenged to improve upon deficiencies in the delivery of patient care. Quality improvement methods are therefore increasingly used in everyday clinical practice. As demonstrated in this review, creative and impactful improvement projects within pediatric gastroenterology can be successfully achieved as either multicenter projects or single-center efforts. Through our willingness to accept the challenge to improve, practitioners within the pediatric gastroenterology community have become leaders in using quality improvement to change practice and improve clinical outcomes...
May 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27977544/outcomes-from-pediatric-gastroenterology-maintenance-of-certification-using-web-based-modules
#20
Josephine Sheu, Stanford Chun, Emily O'Day, Sara Cheung, Rusvelda Cruz, Jenifer R Lightdale, Douglas S Fishman, Athos Bousvaros, Jeannie S Huang
OBJECTIVES: Beginning in 2013, the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) sponsored and developed subspecialty field-specific quality improvement (QI) activities to provide Part 4 Maintenance of Certification (MOC) credit for ongoing certification of pediatric gastroenterologists by the American Board of Pediatrics. Each activity was a Web-based module that measured clinical practice data repeatedly over at least 3 months as participants implemented rapid cycle change...
May 2017: Journal of Pediatric Gastroenterology and Nutrition
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