Spinzi Giancarlo, Milano Angelo, Brosolo Piero, Da Massa Carrara Paola, Labardi Maurizio, Merighi Alberto, Riccardi Luisa, Torresan Francesco
Valduce Hospital, Como, Italy.
Chieti University, Chieti, Italy.
Endosc Int Open. 2020 Mar;8(3):E338-E345. doi: 10.1055/a-1096-0219. Epub 2020 Feb 21.
Accreditation of endoscopy services, using valid quality indicators, may address failures to comply with quality standards between endoscopy services. The aim of this work was to present the Italian Society for Digestive Endoscopy (SIED) accreditation model and its effectiveness. A team of eight endoscopists identified quality indicators derived from international guidelines and assessed them in each center voluntarily requesting accreditation. During a 1-day site visit, two expert endoscopists, the representative of the independent and international administrative certification body and a professional nurse evaluated the endoscopy center, by direct observation of the endoscopy team and examination of the medical records In all centers we noted shortcomings in instrument reprocessing. In 30 of 40 centers (75 %) the information in the nursing charts was incomplete. Sampling for had not been done in 12 of 40 centers (30 %). In six of 40 centers (15 %) the adenoma detection rate for each endoscopist had not been evaluated. Post-polypectomy intervals were inappropriate in 12 of 40 centers (30 %). We noted a statistically significant difference ( < 0.001) between the answers to the SIED checklist of indicators submitted to the inspection team for accreditation before the site visit and the situation found for colonoscopy on site. As of June 30, 2018, 18 endoscopy centers had been accredited and 10 centers had not yet being accredited because they had not completed the measures to correct points raised at the visits. Numerous Italian endoscopy centers fail to meet important quality indicators. Our accreditation program can provide means for detecting these problems and correcting them by implementing SIED standards.
使用有效的质量指标对内镜检查服务进行认证，可能会解决内镜检查服务之间不符合质量标准的问题。这项工作的目的是介绍意大利消化内镜学会（SIED）的认证模式及其有效性。一组八名内镜医师确定了源自国际指南的质量指标，并在每个自愿申请认证的中心对其进行评估。在为期一天的现场考察中，两名专家内镜医师、独立国际行政认证机构的代表和一名专业护士通过直接观察内镜检查团队和检查病历对内镜检查中心进行了评估。在所有中心，我们都注意到器械再处理方面存在缺陷。40个中心中有30个（75%）护理图表中的信息不完整。40个中心中有12个（30%）未进行抽样。40个中心中有6个（15%）未评估每位内镜医师的腺瘤检出率。40个中心中有12个（30%）息肉切除术后间隔时间不合适。我们注意到，在现场考察前提交给检查团队进行认证的SIED指标清单的答案与现场结肠镜检查发现的情况之间存在统计学上的显著差异（<0.001）。截至日2018年6月30日，已有18个内镜检查中心获得认证，10个中心尚未获得认证，因为它们尚未完成纠正考察中提出问题的措施。许多意大利内镜检查中心未能达到重要的质量指标。我们的认证计划可以提供手段来发现这些问题，并通过实施SIED标准来纠正它们。
