The London OMED position statement for credentialing and quality assurance in digestive endoscopy

Abstract

The goal of every clinician (and the health systems in which they work) is to provide high quality medical services. In the case of digestive endoscopy, this means that use of the procedures should adhere to accepted indications, that accurate diagnoses are made, that successful therapies are applied, and that all this is done while maximizing the patient’s comfort, and minimizing the risks. The quality assurance process includes granting of privileges only to competent practitioners, ensuring ongoing competence through re-privileging, and engaging in quality improvement through measurement and remediation. Quality is an issue for everyone involved in the endoscopy process, not just the endoscopists. As a service to the world community, the leadership of OMED (Organisation Mondiale d’Endoscopie Digestive, World Organisation of Digestive Endoscopy) charged Dr. Douglas Faigel and Dr. Peter Cotton to chair a working party of interested endoscopists from a wide range of countries and organizations to develop universal guidelines to assist healthcare institutions in ensuring that the highest quality care be given. The working party met twice, and conducted most of its deliberations by correspondence and conference calls. All known national and international organizations supporting the practice of endoscopy were interrogated for information on relevant topics; many already have extensive publications [1–7]. A list of members of the working party is given in the Appendix. It is well recognized that resources vary around the world, and that digestive endoscopy is regulated in different ways in different countries (and very little in some), so that the application of these guidelines will vary enormously in extent andmethod. However, we believe that the recommendations can provide a useful platform from which all systems can move forward. These guidelines should also be used by educational organizations throughout the world to set goals in their continuing medical education programs, thus improving the quality of endoscopy worldwide. This review does not include discussion of the issues involved in training and credentialing nonphysician endoscopists, which is becoming more common, especially in Britain. However, the same general principles should apply.