Pediatric endoscopy across multiple clinical settings: Efficiency and adverse events

Area of Science:

• Pediatric Gastroenterology
• Health Services Research
• Clinical Efficiency

Background:

• Pediatric endoscopic procedures are vital for diagnosing and treating gastrointestinal disorders.
• The demand for these procedures is rising, necessitating efficient delivery across various care settings.
• Limited data exists on the comparative efficiency of pediatric endoscopy in different clinical environments.

Purpose of the Study:

• To compare the efficiency of pediatric endoscopic procedures across three distinct clinical settings.
• To examine adverse effects associated with these procedures in different environments.

Main Methods:

• A retrospective chart review of 1623 esophagogastroduodenoscopy (EGD) or combined EGD/colonoscopy procedures.
• Procedures were performed by pediatric gastroenterologists in tertiary care OR, community hospital OR, and ambulatory endoscopy center.
• Efficiency was assessed by measuring endoscopist and patient times, with strict inclusion criteria for select patients.

Main Results:

• Endoscopist and patient times were significantly longer in the tertiary care operating room compared to community hospital operating rooms and endoscopy centers.
• The tertiary care setting had longer median endoscopist times (63.3 min) and patient times (133.2 min).
• Adverse events were rare (0.1% in tertiary OR), and 2.2% of all cases required unplanned admission.

Conclusions:

• Pediatric endoscopic procedures can be performed more efficiently in community hospital operating rooms and ambulatory endoscopy centers.
• These findings suggest that select pediatric endoscopic procedures may benefit from being performed in non-tertiary care settings for improved efficiency.