Overcoming the barriers to dissemination and implementation of quality measures for gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology (UEG) position statement

Authors: Raf Bisschops, MatthewD. Rutter, Miguel Areia, Cristiano Spada, Dirk Domagk, Michel F. Kaminski, Andrew
Veitch, Wafaa Khannoussi, Ian M. Gralnek, Cesare Hassan, Helmut Messmann, Thierry Ponchon, Paul Fockens, Alex Dignass, Mario Dinis-Ribeiro

Abstract

The European Society of Gastrointestinal Endoscopy (ESGE) has developed performance measures and established a framework for quality assessment for gastrointestinal endoscopy in Europe. Most national societies actively undertake initiatives to implement and explicitly endorse these quality indicators. Given this, ESGE proposes that, at a national level, strong leadership should exist to disseminate and implement quality parameters. Thus, understanding the potential barriers that may vary locally is of paramount importance. ESGE suggests that each national society should prioritize quality and standards of care in gastrointestinal endoscopy in their activities and should survey/understand which measures are a local priority to their members and make measuring quality intrinsic to daily endoscopy practice.

Introduction

Five years ago, the European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology (UEG) initiated the ESGE quality improvement committee (QIC). The aims of this project were: (1) to improve the global quality of gastrointestinal (GI) endoscopy in Europe and to deliver a patientcentered service in the field of endoscopy; (2) to promote a unifying theme of quality in endoscopy within different activities of the societies; (3) to create a clear quality improvement framework; and (4) to assist all endoscopy units and endoscopists in achieving these standards [1].

From 2015 to 2019, ESGE developed performance measures that allow the assessment of the overall quality of endoscopy in Europe within the various aspects of endoscopy, including the endoscopy service itself [2 – 11]. During every UEG week (UEGW) and ESGE meeting over the last 4 years, the theme of quality was further addressed, and the work of the different working groups was explained to the members and attendees. Finally, the framework for quality assessment and improvement was established and the bar was set. Now it is time for dissemination and implementation of these quality indicators. There are several barriers preventing the immediate adoption of performance measures in daily routine endoscopy, including lack of motivation, resources, and/or leadership. Such barriers may be successfully overcome by a directed and thoughtful dissemination of the performance measures, as well as by the use of educational or technological interventions.

The aim of this Position Statement by ESGE and UEG is to address those barriers that may prevent acceptance and implementation of performance measures in our endoscopy centers and to suggest possible interventions to overcomesuch barriers.