Gestión de la endoscopia digestiva de puertas abiertas y calidad asistencial: equipo de mejora con atención primaria / Management of open access gastrointestinal endoscopy and quality of care: collaboration between an improvement team and primary care

Objetivo Creación y puesta en marcha de un equipo de mejora, dentro de un proyecto de mejora de calidad en salud del Gobierno de Aragón, destinado a incrementar la calidad y el grado de idoneidad de las indicaciones de endoscopia digestiva en el sistema de puertas abiertas en un hospital secundario aragonés. Diseño El equipo desarrolló un documento de consenso donde se recogían las indicaciones y cómo hacer un uso adecuado de la endoscopia oral y la colonoscopia, y realizó una serie de reuniones informativas y formativas con todos los médicos de atención primaria implicados sobre el tema. Emplazamiento Centros de salud del Sector I y Hospital Royo Villanova, de Zaragoza. Participantes El equipo de mejora estaba integrado por un digestólogo y 3 médicos de atención primaria, y contó con el apoyo y respaldo de la Gerencia y la Dirección de atención primaria de su sector sanitario. Resultados Se ha conseguido reducir la inadecuación de endoscopia digestiva, particularmente de colonoscopia, del 20 al 11,6%, un importante ahorro en costes sanitarios, reducir significativamente la lista de espera de endoscopia, mejorar la calidad asistencial y seguridad de los pacientes sometidos a dichas exploraciones, mejorar la formación de los médicos de atención primaria en estos temas e implementar la coordinación asistencial atención primaria-especializada. Conclusiones Para que un sistema de endoscopia digestiva de puertas abiertas a atención primaria funcione de forma eficiente es necesaria la creación de un equipo de mejora interdisciplinario y la total implicación de la atención primaria que maneja ese recurso (AU)

Objective To create an improvement team within a healthcare quality improvement project of the Government of Aragon (Spain), aimed at increasing the quality of care and suitability of the indications of gastrointestinal endoscopy in the open access endoscopy system of a secondary hospital in Aragon. Design The team developed a consensus document indicating how to use oral endoscopy and colonoscopy correctly, and held information and training sessions with all the primary care physicians involved in this area. Location Sector I health centers and Royo Villanova Hospital, in Zaragoza. Participants The team consisted of a gastroenterologist and three primary care physicians and, from the outset received the support of the primary care administration and management in the health area. Results Inappropriate use of endoscopy, particularly colonoscopy, was reduced from 20% to 11.6%. Significant savings were achieved in health costs. The endoscopy waiting list was reduced. The quality of care and the safety of patients undergoing these examinations improved. Training of primary care physicians in these procedures was enhanced, and coordination between primary and specialized was implemented. Conclusions To ensure efficient running of an open access gastrointestinal endoscopy system, an interdisciplinary improvement team and the full involvement of the primary care staff managing this resource are required (AU)

[Management of open access gastrointestinal endoscopy and quality of care: collaboration between an improvement team and primary care]. / Gestión de la endoscopia digestiva de puertas abiertas y calidad asistencial: equipo de mejora con atención primaria.

OBJECTIVE: To create an improvement team within a healthcare quality improvement project of the Government of Aragon (Spain), aimed at increasing the quality of care and suitability of the indications of gastrointestinal endoscopy in the open access endoscopy system of a secondary hospital in Aragon. DESIGN: The team developed a consensus document indicating how to use oral endoscopy and colonoscopy correctly, and held information and training sessions with all the primary care physicians involved in this area. LOCATION: Sector I health centers and Royo Villanova Hospital, in Zaragoza. PARTICIPANTS: The team consisted of a gastroenterologist and three primary care physicians and, from the outset received the support of the primary care administration and management in the health area. RESULTS: Inappropriate use of endoscopy, particularly colonoscopy, was reduced from 20% to 11.6%. Significant savings were achieved in health costs. The endoscopy waiting list was reduced. The quality of care and the safety of patients undergoing these examinations improved. Training of primary care physicians in these procedures was enhanced, and coordination between primary and specialized was implemented. CONCLUSIONS: To ensure efficient running of an open access gastrointestinal endoscopy system, an interdisciplinary improvement team and the full involvement of the primary care staff managing this resource are required.