Search

Your search keyword '"Lorio, A."' showing total 40 results
Start Over Author "Lorio, A." Journal american journal of gastroenterology
40 results on '"Lorio, A."'

27. S0567 Improving Short Term Endoscopy Rates by Schedule Standardization

Author

Grace Hopp, Adam Hughston, Randy Wright, Brenda M. Briones, Pankaj Aggarwal, and Eric A. Lorio

Subjects
medicine.medical_specialty, Hepatology, medicine.diagnostic_test, Coronavirus disease 2019 (COVID-19), Standardization, Esophagogastroduodenoscopy, business.industry, General surgery, Gastroenterology, medicine.disease, Endoscopy, Schedule (workplace), medicine, Chi-square test, Varices, business, Esophagitis
Abstract

INTRODUCTION: Esophagogastroduodenoscopy (EGD) is an important tool for assessing the resolution of high-risk varices, ulcers, and esophagitis At our institution, the process of scheduling surveillance EGD has proven inconsistent This quality improvement study is designed to improve rates of short-term follow-up EGD (4-12 weeks) via standardization of the scheduling process, a change we hope will increase early detection rates of high-risk lesions and facilitate rapid management of threatening conditions METHODS: We retrospectively reviewed 191 EGDs from 1/1/19-4/30/19 Collected variables included recommended follow-up timeframe, whether repeat EGD was performed within the recommended period, evidence of a consult being placed, and the presence or absence of a visit being scheduled Scheduling was then standardized via a newly created form, filled out by fellows/faculty and given directly to scheduling staff Afterwards, an additional 69 charts were reviewed from 1/1/20-1/31/20, and pre and post-intervention rates were compared using chi squared testing RESULTS: Of the pre-intervention cases, 103 had follow up EGD recommended within 4-12 weeks Only 47 6% had an appointment properly scheduled, while 32 0% had an EGD within the recommended timeframe Of the post-intervention cases, 38 patients had a follow up EGD recommended within a 12 week period Of these patients, 81 6% had a visit made after initial EGD, demonstrating a dramatic improvement in the overall rate of properly scheduled appointments (P = 0 01) (Figure 1) When controlling for follow-up indication there was significant improvement in scheduled visits for high-risk varices (P = 0 02), ulcers (P = 0 04), and esophagitis (P = 0 028) (Figure 2) Follow-up EGD was actually performed in the recommended period for 42 1% of post-intervention patients (P = 0 27), When excluding the 10 patients with cancelations due to COVID 19 (3/25-5/3), this number increases to 57 1%, representing a statistically significant increase in EGDswithin the recommended time period (P = 0 01) Conclusion: Clinical expertise plays a large role in identifying high-risk lesions, and the ability to repeat EGDs in a timely manner remains a critical aspect to facilitating excellent patient care As seen in this project, the standardization of logistic processes can have a dramatic effect on follow-up rates for high-risk lesions While our data is affected by COVID 19 cancelations, our increase in successful surveillance indicates a positive shift in scheduling effectiveness

Published
2020
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results