Open AccessPediatric Endoscopy Quality Improvement Network Quality Standards and Indicators for Pediatric Endoscopic Procedures
Author(s) -
Lightdale Jenifer R.,
Walsh Catharine M.,
Oliva Salvatore,
Jacobson Kevan,
Huynh Hien Q.,
Homan Matjaž,
Hojsak Iva,
Gillett Peter M.,
Furlano Raoul I.,
Fishman Douglas S.,
Croft Nicholas M.,
Brill Herbert,
Bontems Patrick,
AmilDias Jorge,
Utterson Elizabeth C.,
Tavares Marta,
Rosh Joel R.,
Riley Matthew R.,
Narula Priya,
Mamula Petar,
Mack David R.,
Liu Quin Y.,
Lerner Diana G.,
Leibowitz Ian H.,
Otley Anthony R.,
Kramer Robert E.,
Ambartsumyan Lusine,
Connan Veronik,
McCreath Graham A.,
Thomson Mike A.
Publication year - 2022
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0000000000003264
Subject(s) - medicine , guideline , grading (engineering) , delphi method , pediatric gastroenterology , quality management , endoscopy , quality (philosophy) , medline , medical physics , hepatology , family medicine , surgery , pathology , operations management , management system , statistics , civil engineering , mathematics , philosophy , epistemology , political science , law , engineering , economics
High‐quality pediatric gastrointestinal procedures are performed when clinically indicated and defined by their successful performance by skilled providers in a safe, comfortable, child‐oriented, and expeditious manner. The process of pediatric endoscopy begins when a plan to perform the procedure is first made and ends when all appropriate patient follow‐up has occurred. Procedure‐related standards and indicators developed to date for endoscopy in adults emphasize cancer screening and are thus unsuitable for pediatric medicine. Methods: With support from the North American and European Societies of Pediatric Gastroenterology Hepatology and Nutrition (NASPGHAN and ESPGHAN), an international working group of the Pediatric Endoscopy Quality Improvement Network (PEnQuIN) used the methodological strategy of the Appraisal of Guidelines for REsearch and Evaluation (AGREE) II instrument to develop standards and indicators relevant for assessing the quality of endoscopic procedures. Consensus was sought via an iterative online Delphi process and finalized at an in‐person conference. The quality of evidence and strength of recommendations were rated according to the GRADE (Grading of Recommendation Assessment, Development, and Evaluation) approach. Results: The PEnQuIN working group achieved consensus on 14 standards for pediatric endoscopic procedures, as well as 30 indicators that can be used to identify high‐quality procedures. These were subcategorized into three subdomains: Preprocedural (3 standards, 7 indicators), Intraprocedural (8 standards, 18 indicators), and Postprocedural (3 standards, 5 indicators). A minimum target for the key indicator, “rate of adequate bowel preparation,” was set at ≥80%. Discussion: It is recommended that all facilities and individual providers performing pediatric endoscopy worldwide initiate and engage with the procedure‐related standards and indicators developed by PEnQuIN to identify gaps in quality and drive improvement.