Quality evaluation through self-assessment: a novel method to gain insight into ERCP performance

Area of Science:

• Gastroenterology
• Medical Quality Assurance
• Endoscopic Procedures

Background:

• The American Society for Gastrointestinal Endoscopy recommends monitoring ERCP-specific quality indicators.
• The Rotterdam Assessment Form for ERCP (RAF-E) was developed as a self-assessment tool for ERCP quality assurance.

Purpose of the Study:

• To evaluate the practical application of the RAF-E for assessing procedural quality in ERCP.
• To determine ERCP quality outcomes within a tertiary referral hospital setting.

Main Methods:

• A prospective study involving five endoscopists at a tertiary referral hospital.
• Utilized the RAF-E to appraise 1691 ERCP procedures performed from January 2008.
• Primary outcomes included common bile duct cannulation rates and overall procedural success, with analysis stratified by procedural difficulty.

Main Results:

• The RAF-E was used in 89.6% (1515) of ERCPs.
• Median common bile duct cannulation success rate was 94.1%.
• High success rates were observed for therapeutic interventions: sphincterotomy (median 100%), stent placement (97.8%), and stone extraction (86.8%).

Conclusions:

• The Rotterdam Assessment Form for ERCP (RAF-E) is a viable tool for measuring ERCP quality indicators.
• Outcome data generated by RAF-E assessment offers insights into individual and group performance.
• The tool can be instrumental in establishing and assessing quality control standards for ERCP.