Gastrointestinal endoscopy clinics of North America
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The desire and requirements for information across the continuum of the enterprise are evident, because outcome measures, quality report cards, and financial pressures effect health care contracting. The real or perceived obstacles to having a comprehensive information management solution (the price tag, the compatibility of hardware and software, multiple locations, ownership of the information, and confidentiality) are so daunting that many are loathe to press ahead. The introduction of modern information technology into the AEC requires a systematic stepwise approach working with trusted partners and stable standards. Intelligent investment in these systems results in a more efficient and effective operating environment based on ongoing data monitoring.
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In the United States sedation and analgesia is the standard of practice when performing upper and lower gastrointestinal endoscopy. Many of these endoscopic procedures are performed in ambulatory endoscopy centers, including ambulatory surgery centers. This article reviews new Joint Commission on Accreditation of Healthcare Organizations standards for sedation and analgesia, drugs used for sedation and analgesia (including side effects), patient assessment and monitoring (before, during, and postprocedure), and discharge of patients from the ambulatory endoscopy center.
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Gastrointest. Endosc. Clin. N. Am. · Apr 2002
ReviewContinuous quality improvement in the ambulatory endoscopy center.
What does quality assessment have to do with the practicing gastroenterologist? Why should one spend the time and effort to incorporate CQI activities into an already busy practice? First and foremost, quality improvement should directly benefit the patient by ensuring that they receive the highest quality of care possible. For example, comparing endoscopic use or outcomes, such as procedure success or complications, with national standards or other endoscopists in the same community may identify physicians who could benefit from additional training. Similar analyses may likewise identify outstanding physicians who might serve as resources for other physicians. ⋯ This new-found attention to quality must be extended to the level of the individual practitioner to ensure that individual patients' interests are protected and the best possible care is delivered regardless of the economic implications. As providers of health care, endoscopists need to take an active role in these efforts both in understanding and implementing the techniques of quality assessment into their practices. If physicians are not actively involved in data collection and measurement to improve the quality and value of their own work, someone else will undoubtedly assume this role.