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内镜逆行胰胆管造影术质量网络:一项关于基准实践与绩效的试点研究

The ERCP quality network: a pilot study of benchmarking practice and performance.

作者信息

Cotton Peter B, Romagnuolo Joseph, Faigel Douglas O, Aliperti Guiseppe, Deal Stephen E

机构信息

Medical University of South Carolina, Charleston, SC 29425-2900, USA.

出版信息

Am J Med Qual. 2013 May-Jun;28(3):256-60. doi: 10.1177/1062860612456235. Epub 2012 Aug 28.

Abstract

There is increasing interest in the quality of endoscopic practice and in documenting it. Endoscopic retrograde cholangiopancreatography (ERCP) is the most complex and risky procedure performed regularly by gastroenterologists. The goal was to test the acceptability and functioning of a voluntary system for individual endoscopists to report details of their ERCP cases and to compare them with unidentified peers. Participants were compared by site of practice, procedure complexity, volumes, durations, and selected technical success rates. There was no independent audit. A total of 63 endoscopists in the United States entered data on 18 182 procedures over 3 years. Results in academic and community practices were similar, but there were significant and expected differences in the complexity of practice and key quality metrics between endoscopists performing more than and fewer than 100 cases per year. The study provided useful data on variations in ERCP practice in the United States and will assist in planning the development of national projects in this field.

摘要

人们对内窥镜操作的质量及其记录越来越感兴趣。内镜逆行胰胆管造影术(ERCP)是胃肠病学家定期进行的最复杂、风险最高的手术。目的是测试一个自愿系统的可接受性和功能,该系统供个体内镜医师报告其ERCP病例的详细信息,并将这些信息与身份不明的同行进行比较。参与者按照执业地点、手术复杂性、手术量、手术时长以及选定的技术成功率进行比较。没有进行独立审计。美国共有63名内镜医师在3年时间里录入了18182例手术的数据。学术机构和社区机构的结果相似,但每年进行超过100例和少于100例手术的内镜医师在手术复杂性和关键质量指标方面存在显著且在意料之中的差异。该研究提供了关于美国ERCP手术差异的有用数据,并将有助于规划该领域国家项目的发展。

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