1. Quality evaluation through self-assessment: a novel method to gain insight into ERCP performance
- Author
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Jelle Haringsma, Ernst J. Kuipers, Robert A. de Man, Arjun D. Koch, Vivian E. Ekkelenkamp, Henk R. van Buuren, and Jan-Werner Poley
- Subjects
Self-assessment ,ENDOSCOPIC RETROGRADE PANCREATOGRAPHY ,medicine.medical_specialty ,Endoscopic retrograde cholangiopancreatography ,Hepatology ,medicine.diagnostic_test ,business.industry ,General surgery ,Gastroenterology ,Psychological intervention ,Endoscopy ,Tertiary referral hospital ,digestive system ,digestive system diseases ,Surgery ,surgical procedures, operative ,Medicine ,GASTROINTESINAL ENDOSCOPY ,Outcomes research ,business ,Prospective cohort study ,Quality assurance - Abstract
Background The American Society for Gastrointestinal Endoscopy Committee on Outcomes Research has recommended monitoring nine endoscopic retrograde cholangiopancreatography (ERCP)-specific quality indicators for quality assurance in ERCP. With the development of a self-assessment tool for ERCP (Rotterdam Assessment Form for ERCP—RAF-E), key indicators can easily be assessed. Objective The aim of this study was to test in daily practice an easy-to-use form for assessment of procedural quality in ERCP and to determine ERCP quality outcomes in a tertiary referral hospital. Design This was a prospective study carried out in a tertiary referral hospital. In January 2008, a quality self-assessment programme was started. Five qualified endoscopists participated in this study. All ERCPs were appraised using RAF-E. Primary parameters were common bile duct (CBD) cannulation rate and procedural success. The indication was classified and procedural difficulty was graded; success rates of therapeutic interventions were measured for all different difficulty degrees. Results A total number of 1691 ERCPs were performed. 1515 (89.6%) of these were appraised using RAF-E. Median CBD cannulation success rate was 94.1%. Successful sphincterotomy was accomplished in almost all patients (median 100%; range 98.2–100%). Stent placement was successful in 97.8% and complete stone extraction, if indicated, was achieved in 86.8%. Conclusions Quality indicators for ERCP can be measured using the Rotterdam self-assessment programme for ERCP. Outcome data in ERCPs obtained with this RAF-E provide insight into the quality of individual as well as group performance and can be used to assess and set standards for quality control in ERCP.
- Published
- 2013
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