Managing underperformance in endoscopy: a pragmatic approach

Abstract

GI endoscopy is increasingly the procedure of choice for the investigation and management of upper and lower GI symptoms. Internationally, key performance indicators (KPIs) are often used to provide key data points and auditable outcomes for endoscopists and endoscopy services with published standards existing for colonoscopy, bowel cancer screening, flexible sigmoidoscopy, ERCP and upper GI endoscopy. Quality assurance (QA) and training programs aim to ensure high skill levels of endoscopists and, supported by quality improvement programs (QI), aim to raise the quality of endoscopy service provision. There are currently few defined processes to guide services where standards are not being met. This document, written by a group of international endoscopy experts, is intended to provide pragmatic guidance to units or programs for managing performance that falls below the desired level. The guidance has been written generically with principals applicable to all endoscopic techniques.