Minnesota Gastroenterology PA and University of Minnesota School of Medicine, Bloomington, Minneapolis, Minnesota 55437, USA.
Curr Opin Gastroenterol. 2012 Sep;28(5):442-50. doi: 10.1097/MOG.0b013e3283561f0d.
This review concerns quality assurance for gastrointestinal endoscopic procedures, especially colonoscopy and will emphasize research and guidelines published since January 2011. Important articles from previous years have been included for background.
Critical lapses in endoscope processing and administration of intravenous sedation alerted us to the infection risk of endoscopy. Increases in cost of colonoscopy, evidence for overuse and studies demonstrating missed cancers have led some to question the value of endoscopy. Despite these setbacks, the National Polyp Study (NPS) consortium published their long-term follow-up of the original NPS patients and confirmed that colonoscopy with polyp removal can reduce the risk of colorectal cancer for an extended period. In this article, we will focus on ways to improve the value of outpatient colonoscopy.
The United States national quality improvement agenda recently became organized into a more coordinated effort spearheaded by several public and private entities. They comprise the infrastructure by which performance measures are developed and implemented as accountability standards. Understanding wherein a gastroenterology (GI) practice fits into this infrastructure and learning ways we can improve our endoscopic practice is important for physicians who provide this vital service to patients. This article will provide a roadmap for developing a quality assurance program for endoscopic practice.
本文主要关注胃肠道内镜检查（尤其是结肠镜检查）的质量保证，重点介绍 2011 年 1 月以来的研究和指南。为了介绍背景，文中也包含了前几年的重要文章。
内镜处理和静脉镇静管理方面的重大失误使我们意识到内镜检查存在感染风险。结肠镜检查费用的增加、过度使用的证据以及表明漏诊癌症的研究，使得一些人对内镜检查的价值提出了质疑。尽管存在这些挫折，国家息肉研究（NPS）联盟发表了他们对原始 NPS 患者的长期随访结果，并证实结肠镜检查结合息肉切除可以在较长时间内降低结直肠癌的风险。在本文中，我们将重点关注如何提高门诊结肠镜检查的价值。
美国国家质量改进计划最近变得更加协调，由几个公共和私人实体牵头。它们构成了制定和实施绩效衡量标准作为问责制标准的基础。了解胃肠病学（GI）实践在这一基础设施中的定位，并学习改进内镜实践的方法，对于为患者提供这项重要服务的医生来说非常重要。本文将为内镜实践的质量保证计划的制定提供路线图。
