How to implement adverse events as a quality indicator in gastrointestinal endoscopy

Quality improvement through the registration of endoscopy-related adverse events (AEs) has been recognized by major international endoscopy societies as an important quality indicator. The theory behind this is easier to approve than its implementation in daily practice. The results of many valuable attempts have been published in the literature, mainly highlighting the diverse hurdles trying to capture events related to endoscopy and the sedation used for endoscopic procedures. The current review discusses the difficulties encountered attempting to register AEs and incidents related to endoscopic procedures. Government-driven and financed health-care databases with automated coupling of specific data seem the only efficient way to implement endoscopy-related AEs and outcomes on a prospective and complete basis. This will not only allow continuous confidential feedback to endoscopists in relation to the pooled national benchmark data, but also follow-up in time through data-driven credentialing aiming to progressively optimize these benchmark data.

Automated summary

Quality improvement through registration of endoscopy-related AEs is recognized as an important indicator, but implementation in daily practice is challenging. Literature highlights the difficulties in capturing endoscopy-related events and sedation-related incidents. Government-driven health-care databases with automated data coupling are the most efficient way to implement comprehensive endoscopy-related AEs and outcomes, allowing feedback and credentialing based on national benchmark data.