Suqing Li, Seremi Ibadin, Christina R Studts, Susan E Jelinski, Steven J Heitman, Robert J Hilsden, Rachid Mohamed, Arjun Kundra, Peter McCulloch, Gregory A Coté, James M Scheiman, Rajesh N Keswani, Sachin Wani, B Joseph Elmunzer, Khara M Sauro, Nauzer Forbes
{"title":"Development and usability of an endoscopist report card assessing ERCP quality.","authors":"Suqing Li, Seremi Ibadin, Christina R Studts, Susan E Jelinski, Steven J Heitman, Robert J Hilsden, Rachid Mohamed, Arjun Kundra, Peter McCulloch, Gregory A Coté, James M Scheiman, Rajesh N Keswani, Sachin Wani, B Joseph Elmunzer, Khara M Sauro, Nauzer Forbes","doi":"10.1016/j.gie.2024.10.010","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aims: </strong>Audit and feedback (A&F) for ERCP is relatively understudied despite the demonstrated effectiveness of A&F for endoscopic procedures such as colonoscopy. Endoscopist \"report cards\" are one such A&F tool. We aimed to develop an ERCP report card and assess its appropriateness, acceptability, and feasibility through usability testing.</p><p><strong>Methods: </strong>A prototype report card was designed using a combination of published quality indicators and established predictors of adverse events (AEs). Exploratory analyses from a prospective multicenter registry were performed to further identify novel and/or understudied parameters for possible inclusion. Semistructured interviews with ERCP endoscopists were conducted and framework analysis performed. Validated postinterview usability instruments were administered. Feedback was incorporated to create a final report card.</p><p><strong>Results: </strong>The report card included domains of technical parameters, AE rates and prevention, and patient-reported experience measures (PREMs). Qualitative feedback was positive, with respondents agreeing with inclusion of relevant content in most domains. Postinterview instruments revealed adequate appropriateness and acceptability. PREMs were believed by respondents to be poorly actionable and were replaced with appropriateness of indication and fluoroscopy usage parameters in the final report card. Concerns were raised regarding the feasibility of implementation because of reliance on difficult-to-obtain granular intraprocedural data.</p><p><strong>Conclusions: </strong>We designed and tested an ERCP report card that has the potential to be an effective A&F intervention for endoscopists in clinical practice. Although feasibility of data capture and implementation are currently limitations, advances in video recording and artificial intelligence technologies could accelerate widespread adoption of such a tool.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7000,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastrointestinal endoscopy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.gie.2024.10.010","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and aims: Audit and feedback (A&F) for ERCP is relatively understudied despite the demonstrated effectiveness of A&F for endoscopic procedures such as colonoscopy. Endoscopist "report cards" are one such A&F tool. We aimed to develop an ERCP report card and assess its appropriateness, acceptability, and feasibility through usability testing.
Methods: A prototype report card was designed using a combination of published quality indicators and established predictors of adverse events (AEs). Exploratory analyses from a prospective multicenter registry were performed to further identify novel and/or understudied parameters for possible inclusion. Semistructured interviews with ERCP endoscopists were conducted and framework analysis performed. Validated postinterview usability instruments were administered. Feedback was incorporated to create a final report card.
Results: The report card included domains of technical parameters, AE rates and prevention, and patient-reported experience measures (PREMs). Qualitative feedback was positive, with respondents agreeing with inclusion of relevant content in most domains. Postinterview instruments revealed adequate appropriateness and acceptability. PREMs were believed by respondents to be poorly actionable and were replaced with appropriateness of indication and fluoroscopy usage parameters in the final report card. Concerns were raised regarding the feasibility of implementation because of reliance on difficult-to-obtain granular intraprocedural data.
Conclusions: We designed and tested an ERCP report card that has the potential to be an effective A&F intervention for endoscopists in clinical practice. Although feasibility of data capture and implementation are currently limitations, advances in video recording and artificial intelligence technologies could accelerate widespread adoption of such a tool.
期刊介绍：
Gastrointestinal Endoscopy is a journal publishing original, peer-reviewed articles on endoscopic procedures for studying, diagnosing, and treating digestive diseases. It covers outcomes research, prospective studies, and controlled trials of new endoscopic instruments and treatment methods. The online features include full-text articles, video and audio clips, and MEDLINE links. The journal serves as an international forum for the latest developments in the specialty, offering challenging reports from authorities worldwide. It also publishes abstracts of significant articles from other clinical publications, accompanied by expert commentaries.
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