Abstract:
BACKGROUND AND AIMS:Patient and procedure verification, or the time-out process (TOP), is considered one of the most vital components of patient safety. It has long been a focus of intervention in the surgical community and recently was incorporated into the American Society for Gastrointestinal Endoscopy guidelines for safety in the GI endoscopy unit. The TOP has had limited attention in the endoscopy literature but remains an area for improvement in clinical endoscopy practice. The aim of this study was to identify barriers and improve TOP compliance rates in our endoscopy unit using remote video auditing (RVA). METHODS:This was a single-center, prospective, pilot initiative in an endoscopy unit at a tertiary care academic medical center. Video cameras with offsite monitoring were installed in each procedure room in our endoscopy suite in November 2016. Baseline TOP compliance rates were audited with RVA over a 2-month period. A multidisciplinary quality improvement team reviewed the data, identified barriers to the TOP, and implemented actionable items in January 2017. TOP compliance rates were again monitored via RVA, and data were collected through October 2018. Pre- and postintervention TOP compliance rates were compared. RESULTS:Over the baseline period, 692 procedures were audited and TOP compliance documented. Baseline TOP compliance rate was 69.6%. Identifiable barriers to TOP compliance included a lack of designated team member to lead TOP, inconsistent documentation of TOP, irrelevant safety checklist items not applicable to endoscopic procedures, and lack of patient safety culture. Actionable items implemented in response to these barriers included designation of a TOP leader, visual indication of initiation of TOP, creation of a concise endoscopy-specific safety checklist, and formal notification/education of the entire endoscopy team. Postintervention TOP compliance rates were then audited from January 2017 to October 2018 and included 12,008 procedures. The mean TOP compliance rate significantly improved from baseline (95.3% vs 69.6%; 95% confidence interval, 22.4-29.3; P < .0001). Additionally, the improvement was maintained throughout the entire postintervention observation period. CONCLUSIONS:TOP compliance rates significantly improved in our endoscopy unit through the use of RVA and implementation of 4 actionable items. Future studies should evaluate the reproducibility of this method in other endoscopy units.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Raphael K,Cerrone S,Sceppa E,Schneider P,Laumenede T,Lynch A,Sejpal DVdoi
10.1016/j.gie.2019.04.237subject
Has Abstractpub_date
2019-09-01 00:00:00pages
424-429issue
3eissn
0016-5107issn
1097-6779pii
S0016-5107(19)31664-5journal_volume
90pub_type
杂志文章abstract:BACKGROUND:Healing of mucosal lesions appears to offer significant benefit and is an important end point in clinical trials of treatment for Crohn's disease. The only validated endoscopic activity score at present is the Crohn's Disease Endoscopic Index of Severity, which is complicated and time consuming and, hence, i...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)01878-4
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:Complications after endoscopic biliary sphincterotomy occur in 8% to 10% of patients when studied prospectively. It is not known whether the type of electrocautery current affects this rate. Theoretically, less edema of the ampulla after a pure cutting current sphincterotomy could decrease the risk of pancre...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0016-5107(98)70348-7
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND AND AIMS:Reports on the performance of unsedated ultrathin endoscopy via the transnasal (uTNE) and transoral (uTOE) routes are conflicting. We aimed to estimate the technical success rate, patient preference, and acceptability of uTNE and uTOE alone and in comparison with conventional EGD (cEGD; with or with...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.gie.2015.07.016
更新日期:2015-11-01 00:00:00
abstract::Monopolar hot biopsy forceps were developed for simultaneous tissue biopsy and electrocoagulation. Many endoscopists used these forceps for coagulation of diminutive polyps of the colon. The rationale for diminutive polyp eradication is to destroy neoplastic tissue and possibly prevent colon cancer. However, convincin...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND AND AIMS:Schatzki rings are found in the distal esophagus, are associated with hiatal hernias, and present with intermittent dysphagia to solid foods. They can be identified by radiology (GI series or barium swallow studies) or endoscopy. Rings are not always visualized during endoscopy in patients in whom t...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2015.10.041
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Silastic rings are used in gastric bypass procedures for the treatment of obesity, but ring slippage may lead to gastric pouch outlet stenosis (GPOS). Conventional management has been ring removal through abdominal surgery. OBJECTIVE:To describe a novel, safe, minimally invasive, endoscopic technique for th...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2010.01.057
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND AND AIMS:Accidental and intentional foreign body ingestions are common and frequently require endoscopic intervention. Sharp metallic objects pose a risk of perforation to the entire GI tract and are often difficult to visualize among food and other matter in the stomach. METHODS:Three patients with histori...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2019.10.023
更新日期:2020-02-01 00:00:00
abstract::We evaluated a computerized report-generating system using voice recognition technology (EndoSpeak) for producing therapeutic ERCP reports. For 30 consecutive ERCP cases, reports using both EndoSpeak and standard dictation were generated at the end of the procedure. The cases were scored for overall difficulty and the...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(91)70866-3
更新日期:1991-11-01 00:00:00
abstract:BACKGROUND AND AIMS:The effect of Helicobacter pylori eradication on de novo gastric cancer is controversial, although meta-analyses suggest a reduction in gastric cancer after eradication. The effect of high-density lipoprotein (HDL) on gastric cancer has been rarely reported. METHODS:In this large retrospective coho...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2019.04.232
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:In children, endoscopic sclerotherapy and variceal ligation (EVL) are the most used techniques for the treatment of gastroesophageal variceal bleeding (VB). However, these techniques achieve poor results in cases of gastric variceal bleeding, and EVL is not applicable in young infants. OBJECTIVE:Our purpose...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.07.025
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND AND AIMS:False positive (FP) results by computer-aided detection (CADe) hamper the efficiency of colonoscopy by extending examination time. Our aim was to develop a classification of the causes and clinical relevance of CADe FPs, and to assess the relative distribution of FPs in a real-life setting. METHODS...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2020.06.021
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:There is increasing interest in natural orifice surgery (NOS). Because the lumen of the appendix is connected to the cecum, a minimally invasive method for removing the appendix by colonoscopy may be feasible. OBJECTIVES:Our purpose was to design, develop, and test new devices for inverting and removing the...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.02.024
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND AND AIMS:Numerous randomized studies have shown that changing certain features of colonoscopes, usually incorporated when switching from one endoscope generation to the next, mostly do not increase adenoma yield. There is, however, indirect evidence that it may be necessary to skip one instrument generation ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.gie.2018.01.025
更新日期:2018-07-01 00:00:00
abstract::The feasibility of infrared video imaging of subsurface vessels in the stomach was investigated both experimentally and in more detail using computer simulations of light propagation. Infrared video imaging was first attempted in several experimental situations. Images of a human arm illuminated with infrared light (w...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(95)70341-1
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND AND AIMS:A structured comprehensive curriculum (SCC) that uses simulation-based training (SBT) can improve clinical colonoscopy performance. This curriculum may be enhanced through the application of progressive learning, a training strategy centered on incrementally challenging learners. We aimed to determi...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2017.03.1529
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Monopolar hot biopsy forceps (HBF), bipolar HBF, and cold biopsy forceps (CBF) followed by bipolar electrocoagulation are used clinically to simultaneously perform a biopsy and coagulate diminutive colon polyps and angiomata. Our purpose was to conduct a randomized, controlled study to evaluate the safety of...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(95)70013-7
更新日期:1995-12-01 00:00:00
abstract::ERCP was performed in two infants (29 and 62 days old) and eight children (5 to 12 years old) with jaundice due to common bile duct stones. Seven patients had hemolytic anemia and three patients had a family history of gallstone disease. Successful cannulation of the common bile duct demonstrating stones was accomplis...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(92)70475-1
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:We sought to determine the histologic effects of metal stent placement on tumor tissue and on normal tissue proximal and distal to the tumor in patients with expandable metal stents implanted in vivo. METHODS:Twelve patients with 10 to 16 mm uncovered Wallstents were studied, 5 with esophageal stents, 4 wit...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(96)70198-0
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND AND AIMS:Markedly increased liver chemistries in patients presenting with acute calculous cholecystitis (AC) often prompt an evaluation for concomitant choledocholithiasis (CDL). However, current guidelines directing the workup for CDL fail to address this unique population. The aims of this study are to def...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2018.11.017
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND AND AIMS:Almost all patients with familial adenomatous polyposis (FAP) develop duodenal adenomas, with a 4% to 18% risk of progression into duodenal cancer. Prophylactic endoscopic resection of duodenal adenomas may prevent cancer and is considered safer than surgical alternatives; however, data are limited....
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2020.05.065
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND:Forming anastomoses between two hollow organs at flexible endoscopy might reduce the need for surgery for obstructing malignancy. Current methods require access to both lumens. The aim of this work was to develop methods of forming an anastomosis at flexible endoscopy, such as a gastrojejunostomy or cholecys...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,评审
doi:10.1016/s0016-5107(03)02006-6
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:Recent studies highlight the role of duodenal bulb biopsy in the diagnosis of celiac disease. OBJECTIVE:To determine whether a targeted duodenal bulb biopsy in addition to distal duodenal biopsies is the optimal strategy to identify villous atrophy. DESIGN:Prospective cohort study. SETTING:Tertiary-care r...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2012.02.025
更新日期:2012-06-01 00:00:00
abstract::Guide wires have become an essential part of therapeutic biliary and pancreatic endoscopy. The Teflon-painted stainless steel wire still remains the standard guide wire. However, special situations call for the use of some of the more specialized guide wires mentioned in this article. The endoscopist needs to be famil...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,评审
doi:10.1016/s0016-5107(96)70262-6
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Urgent colonoscopy is not always the preferred initial intervention in severe lower GI bleeding because of the need for a large volume of oral bowel preparation, the time required for administering the preparation, and concern regarding adequate visualization. OBJECTIVE:To evaluate the feasibility, safety, ...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/j.gie.2012.03.1391
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Pancreatic/peripancreatic tuberculosis (TB) is a very rare clinical entity, even in countries with high incidences of TB. The diagnosis of pancreatic/peripancreatic TB with EUS-guided FNA (EUS-FNA) remains a diagnostic challenge because of limitations of the endoscopists' expertise on this condition. OBJECT...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.10.007
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Neoadjuvant chemoradiotherapy followed by surgery is the primary treatment option for patients with locally advanced esophageal cancer. This multicenter phase I trial examined intratumoral injection of TNFerade biologic, an adenoviral vector that expresses the human tumor necrosis factor-α gene, with chemora...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2012.01.042
更新日期:2012-06-01 00:00:00
abstract::The long-term effects of endoscopic dilation of colonic or ileo-colonic Crohn's disease strictures were analyzed. In 18 patients with a Crohn's disease-related low gastrointestinal stricture, the stenosis was dilated using through-the-scope (TTS) balloon catheters. A dilation to a diameter of 18 mm was always attempte...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(92)70379-4
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:In EMR of early gastric cancer (EGC), en bloc resection reduces the risk of residual cancer. Endoscopic submucosal dissection (ESD) now allows en bloc resection of large EGCs. OBJECTIVE:To retrospectively determine whether ESD is more advantageous than EMR for EGCs. DESIGN:EMR (825 lesions, 711 patients) o...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2006.03.932
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Deep cannulation of the dorsal duct in patients with pancreas divisum may not be possible, even for the experienced endoscopist. This is a description of a technique to facilitate access to the dorsal duct. METHODS:Patients undergoing dorsal ductography in whom endoscopic therapy was indicated and in whom a...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2001.115474
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:A trucut needle biopsy device that can be used to obtain specimens from the pancreas and other perigastric organs under EUS guidance has been developed and successfully tested in animals. Moreover, EUS-guided trucut needle biopsy has been used safely in humans and appears to provide more accurate results tha...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(03)02538-0
更新日期:2004-02-01 00:00:00