Every year during Digestive Disease Week®, AGA hosts a session titled “Advancing Clinical Practice: GI Fellow-Directed Quality-Improvement Projects.” This year 16 quality improvement (QI) initiatives were selected — you can review these abstracts in this month’s issue of Gastroenterology in the “AGA Section” or review a presenter’s abstract by clicking their image. Congratulations to the promising fellows featured below, who all served as lead authors for their QI projects.
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Ahmad Alkaddour, MD
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Cary Cotton, MD, MPH
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Sonya Dasharathy, MD
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Juan D. Gomez Cifuentes, MD
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Shida Haghighat, MD
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Avni Jain, MD
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Daniel Lew, MD
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Hammad Liaquat, MD
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Valentine Millien, MD
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Sobia Mujtaba, MD
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Navine Nasser-Ghodsi, MD
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Brendon O’Connell, MD
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Benjamin Robey, MD
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Sharmistha Rudra, MD
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Aditya Sreenivasan, MD
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Chung Sang Tse, MD
Ahmad Alkaddour, MD
Augusta University
We found that using the Tokyo guidelines improved GI consult fellows’ overall accuracy in detecting acute cholangitis requiring ERCP across fellowship years.
Cary Cotton, MD, MPH
University of North Carolina
We were astounded by the amount and variability of costs for single-use equipment at our division’s endoscopy sites. As we considered how to optimize this healthcare spending to benefit our patients, we found that an initial barrier was very little knowledge of the cost of this equipment among the clinicians who routinely decide which tools to use.
Sonya Dasharathy, MD
University of California, Los Angeles Vatche and Tamar Manoukian Division of Digestive Diseases
In our survey study of providers and patients, the main barrier to not completing pneumococcal vaccination was a lack of recommendation by providers. Based on our results, we developed interventions to improve provider knowledge on the indications for pneumococcal vaccination in patients with IBD and make it easier to order these vaccines in the clinic.
Juan D. Gomez Cifuentes, MD
Baylor College of Medicine
Qualitive Improvement Initiative to Eliminate Inpatient Fecal Occult Blood Testing
To improve inappropriate use and overutilization of fecal occult blood test in our hospital, we decided to withdraw fecal occult blood test from inpatient medical orders to guarantee a long-term solution.
Shida Haghighat, MD
University of Miami
Surgical masks often ride up during endoscopy/colonoscopy and can cause corneal abrasions. A simple quality improvement intervention of taping surgical masks to the nasal bridge dramatically decreased post-endoscopic corneal abrasions which were notably higher during the COVID-19 era.
Avni Jain, MD
University of Manitoba
Our study suggests that use of an informative online platform such as the mycolonoscopy.ca website developed by staff at our institution helps to improve patient education prior to colonoscopy, reduce anxiety and stress surrounding the procedure, and improve bowel cleansing score.
Daniel Lew, MD
Cedars-Sinai Medical Center
Managing acute iatrogenic endoscopic perforations is stressful and requires multiple interventions among different providers in a time-sensitive manner. We sought to develop a perforations management algorithm to help as a guide and to educate physicians about perforations to improve patient outcomes.
Hammad Liaquat, MD
St Luke’s University Health Network
Our improved OP-29 compliance reduced colonoscopy overutilization, improved healthcare quality and reduced health care costs for our patients and our health network.
Valentine Millien, MD
Baylor College of Medicine
We were interested to see how well our institution adhered to intestinal metaplasia surveillance and in the future if this would make a difference in the rates of gastric cancer.
Sobia Mujtaba, MD
Emory University
Improving Colorectal Cancer Screening and Polyp Surveillance During the COVID-19 Pandemic
Addressing patients’ peri-procedural concerns during this pandemic is crucial to promote elective, but necessary colonoscopies for colorectal cancer screening and polyp surveillance to avoid a large burden of missed cancers in the future.
Navine Nasser-Ghodsi, MD
Mayo Clinic-Rochester
The inclusion of a clinical pharmacist in the inflammatory bowel disease care team improves the rate of vaccine completion by over 50%, particularly the influenza vaccine.
Brendon O’Connell, MD
Duke University
Using a multi-faceted approach, we were able to improve physician documentation of anticoagulants and antiplatelet agents after endoscopic procedures over time to address confusion of patients and the care team upon discharge.
Benjamin Robey, MD
University of Virginia
We were interested in ensuring that our practice was making clear anticoagulation management recommendations for endoscopy and colonoscopy patients. A simple reminder within endoscopy reporting software improves post procedure documentation of anticoagulation plan.
Sharmistha Rudra, MD
Children’s Hospital of Philadelphia
This QI initiative of improving access to influenza vaccines during scheduled inflammatory bowel disease (IBD) therapy infusion appointments increased vaccination uptake by 22% (45.5% to 67.4%). The QI initiative was formulated during the COVID-19 pandemic to optimize influenza vaccination uptake in immunocompromised IBD patients with ongoing healthcare appointments.
Aditya Sreenivasan, MD
Zucker School of Medicine at Hofstra/Northwell
The Timing of Inpatient Diagnostic Paracenteses: An Opportunity to Improve
The inability to perform timely diagnostic paracenteses in line with society guidelines at our academic institution is a result of several clinical and logistical hurdles that must be overcome to provide high quality patient care.
Chung Sang Tse, MD
Brown University
In this 28-month QI study, we educated the hospital house staff on the risk of chronic steroid use in patients discharged for IBD flares and created a 6-week prednisone taper order set in the EMR, which led to a decrease of chronic steroid use (24% to 7%).
