PWE-013 Quality in endoscopy: a retrospective audit of image documentation in upper gi endoscopy

Abstract

Introduction Quality assurance is an integral part of endoscopy with image documentation playing a fundamental role. The European Society of Gastrointestinal Endoscopy (ESGE) Quality assurance Committee has generated recommendations for systematic image documentation. Adherence to these standards provides quality assurance and facilitates international multicentre collaboration. The aim of this study is to audit current practice of image documentation in upper GI endoscopy in a large district general hospital and explore any impact on procedure duration and patient tolerance. Method Retrospective analysis was performed on endoscopy reports for all upper GI endoscopies performed during a one month period in October 2014. Reports were accessed from the hospital endoscopy reporting system (HICSS) and analysed to compare image documentation with the eight anatomic locations as set out in the ESGE guidelines. The endoscopist’s specialty and image number, location and quality were recorded. Tolerance scores and procedure duration were also analysed. Results 551 upper GI endoscopies were performed. 516 upper GI endoscopy reports with 3526 images were analysed. 170 were performed by surgical endoscopists, 346 by physician endoscopists. 160 procedures (31%) had no images recorded. The mean number of images taken by surgeons was 3.6 (range 0–38) and physicians 8.5 (0–79). Image clarity ranged from 46% (GOJ) to 66% (duodenal bulb). Conclusion Image documentation during gastroscopy is inconsistent, with poor adherence to guidelines. In an era where demand for quality control in endoscopy is gaining force a consistent approach is essential. ESGE recommendations provide a framework for standardisation. We found no clear association between the number or quality of images taken and procedure duration or tolerance scores. We plan to re-audit following education to reassess standards. Disclosure of interest None Declared. References Rey JF, Lambert R. ESGE recommendations for quality control in gastrointestinal endoscopy: guidelines for image documentation in upper and lower GI endoscopy. Endoscopy. 2001;33(10):901–3 Korman LY. Standardization in endoscopic re- porting:Implications for clinical practice and research. J Clin Gastroenterol. 1999;28:217-223 Sivak MV Jr. Endoscopy databases and endoscopic research. GI Endosc. 2000;51:243–244