Quality indicators in digestive endoscopy: introduction to structure, process, and outcome common indicators

Area of Science:

• Gastroenterology
• Health Services Research
• Quality Improvement

Background:

• Digestive endoscopy units require standardized quality and safety procedures.
• Existing literature on quality indicators for endoscopy is fragmented.
• Expert consensus is needed to define key performance metrics.

Purpose of the Study:

• To propose quality and safety procedures and indicators for digestive endoscopy.
• To establish a framework for quality improvement in endoscopy units.
• To identify indicators applicable across all digestive endoscopy procedures.

Main Methods:

• Development of a pre- and post-procedure workflow diagram.
• Qualitative literature review by experts from the Spanish Society of Digestive Diseases.
• Paired analysis for literature selection and review.
• Quality of evidence assessment using the GRADE classification.

Main Results:

• Twenty quality indicators were identified: 7 structural, 11 process (5 pre-, 3 intra-, 3 post-procedure), and 2 outcome indicators.
• Indicators were systematically selected and reviewed based on literature.
• Evidence quality for each indicator was assessed using the GRADE system.

Conclusions:

• The identified indicators provide a foundation for enhancing quality and safety in digestive endoscopy.
• Standardized procedures and measurable indicators are crucial for quality improvement initiatives.
• Further research may refine these indicators and their implementation strategies.