Mobile Health technology in pediatric esophagogastroduodenoscopy quality indicators assessment: results from a national program of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition.

Nationwide survey Pediatric endoscopy Quality improvement Smartphone. Research

Journal

Gastrointestinal endoscopy
ISSN: 1097-6779
Titre abrégé: Gastrointest Endosc
Pays: United States
ID NLM: 0010505

Informations de publication

Date de publication:
19 Mar 2024
Historique:
received: 06 02 2024
revised: 10 03 2024
accepted: 13 03 2024
medline: 22 3 2024
pubmed: 22 3 2024
entrez: 21 3 2024
Statut: aheadofprint

Résumé

Upper endoscopy procedures (UEP, esophagogastroduodenoscopy [EGDS] and retrograde endoscopic retrograde cholangiography [ERCP]) are an established standard of care in pediatric gastroenterology. The Pediatric endoscopy quality improvement network (PEnQuIN) recently published its pediatric-specific endoscopy quality guidelines. This study, initiated by the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP), aims to evaluate the adherence of Italian Pediatric Endoscopy Centers to these established quality standards. Conducted between April 2019 and March 2021, this nationwide study utilized a smartphone app-based approach. Data encompassing pediatric endoscopy facilities, patient profiles, endoscopy indications, 17 procedure-related PEnQuIN indicators, and a GHAA-9m patient satisfaction questionnaire were systematically collected. A comprehensive analysis of 3582 procedures from 24 PECs revealed that 2654 (76%) were UEP. The majority of centers (75%) involved more than one operator, with 9 PEC incorporating adult endoscopists, responsible for 5% of UEPs. Overall, adherence to quality standards was good; however, areas of improvement include sub-optimal reporting of sedation details, adherence to disease-specific guidelines, and patient satisfaction questionnaire completeness (56%). The complication rate aligned with literature standards (1%), and patient satisfaction was generally high. A noteworthy observation was a 30% decrease monthly reporting rate and a shift in disease-specific patterns following the COVID-19 outbreak. Pediatric UEP practices in Italy adhere well to established quality standards. Emphasizing the adoption of disease-specific guidelines is crucial for optimizing resources, enhancing diagnostic accuracy, and minimizing unnecessary procedures. Prioritizing patient satisfaction is important for immediate enhancements in practice as well as for future research endeavors.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
Upper endoscopy procedures (UEP, esophagogastroduodenoscopy [EGDS] and retrograde endoscopic retrograde cholangiography [ERCP]) are an established standard of care in pediatric gastroenterology. The Pediatric endoscopy quality improvement network (PEnQuIN) recently published its pediatric-specific endoscopy quality guidelines. This study, initiated by the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP), aims to evaluate the adherence of Italian Pediatric Endoscopy Centers to these established quality standards.
METHODS METHODS
Conducted between April 2019 and March 2021, this nationwide study utilized a smartphone app-based approach. Data encompassing pediatric endoscopy facilities, patient profiles, endoscopy indications, 17 procedure-related PEnQuIN indicators, and a GHAA-9m patient satisfaction questionnaire were systematically collected.
RESULTS RESULTS
A comprehensive analysis of 3582 procedures from 24 PECs revealed that 2654 (76%) were UEP. The majority of centers (75%) involved more than one operator, with 9 PEC incorporating adult endoscopists, responsible for 5% of UEPs. Overall, adherence to quality standards was good; however, areas of improvement include sub-optimal reporting of sedation details, adherence to disease-specific guidelines, and patient satisfaction questionnaire completeness (56%). The complication rate aligned with literature standards (1%), and patient satisfaction was generally high. A noteworthy observation was a 30% decrease monthly reporting rate and a shift in disease-specific patterns following the COVID-19 outbreak.
CONCLUSIONS CONCLUSIONS
Pediatric UEP practices in Italy adhere well to established quality standards. Emphasizing the adoption of disease-specific guidelines is crucial for optimizing resources, enhancing diagnostic accuracy, and minimizing unnecessary procedures. Prioritizing patient satisfaction is important for immediate enhancements in practice as well as for future research endeavors.

Identifiants

DOI: 10.1016/j.gie.2024.03.019 PMID: 38513921
pubmed: 38513921
pii: S0016-5107(24)00180-9
doi: 10.1016/j.gie.2024.03.019
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Auteurs

Lorenzo Norsa (L)

Pediatric Hepatology Gastrosenterology and Transplantation Unit, ASST Papa Giovanni XXIII, Bergamo, Italy; Deparment of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy. Electronic address: lonorsa@hotmail.com.

Francesco Morotti (F)

Division of Pediatrics, Department of Health Sciences, Università degli Studi del Piemonte Orientale, Novara, Italy; Neonatology and Neonatal Intensive Care Unit, Spedali Civili Children's Hospital, Brescia, Italy.

Cecilia Mantegazza (C)

Deparment of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy.

Milena Meroni (M)

Department of Pediatric Surgery, Vittore Buzzi Children's Hospital, Milan, Italy.

Marco Deganello Saccomani (M)

Department of Pediatrics, Woman's & Child's University Hospital of Verona, Italy.

Claudia Banzato (C)

Department of Pediatrics, Woman's & Child's University Hospital of Verona, Italy.

Barbara Parma (B)

Department of Pediatric, Mariani Foundation Center for Fragile Child. ASST-Lariana, Sant'Anna Hospital, San Fermo della Battaglia, Como, Italy.

Giulia Franchino (G)

Department of Pediatric, Mariani Foundation Center for Fragile Child. ASST-Lariana, Sant'Anna Hospital, San Fermo della Battaglia, Como, Italy.

Giovanni Di Nardo (G)

Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Pediatric Unit, Sant'Andrea University Hospital, Rome, Italy.

Naire Sansotta (N)

Pediatric Hepatology Gastrosenterology and Transplantation Unit, ASST Papa Giovanni XXIII, Bergamo, Italy.

Paolo Orizio (P)

Department of Pediatric Surgery, Spedali Civili Children's Hospital, Brescia, Italy.

Emanuele Dabizzi (E)

Gastroenterology and Interventional Endoscopy Unit, AUSL Bologna, Surgical Department, Bologna, Italy.

Giorgio Raffaele Fava (GR)

Department of Pediatric Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Andrea Chiaro (A)

Pediatric Gastroenterology and Endoscopy Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy.

Maristella Pellegrino (M)

Pediatric Surgery Departement, ASST GOM Niguarda, Milan - Italy.

Fabiola Fornaroli (F)

Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.

Antonio Pizzol (A)

Pediatric Gastroenterology Unit, Regina Margherita Children's Hospital, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.

Caterina Strisciuglio (C)

Department of Woman, Child, General and Specialistic Surgery, University of Campania "Luigi Vanvitelli," Naples, Italy.

Caterina Pacenza (C)

Department of Pediatrics, San Giovanni di Dio Hospital, Crotone, Italy.

Cosimo Ruggiero (C)

Pediatric Gastroenterology and Liver Unit, Maternal and Child Health Department, Sapienza University of Rome, Rome, Italy.

Giusy Russo (G)

Pediatric Gastroenterology and Liver Unit, Maternal and Child Health Department, Sapienza University of Rome, Rome, Italy.

Salvatore Oliva (S)

Pediatric Gastroenterology and Liver Unit, Maternal and Child Health Department, Sapienza University of Rome, Rome, Italy.

Classifications MeSH