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Meet the 16 fellows making great progress in GI patient care

Congratulations to these fellows showcasing their commitment to advancing our field through their quality improvement projects.
16 Fellows QI_2021
16 Fellows QI_2021

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.

  • Ahmad Alkaddour, MD

    Ahmad Alkaddour, MD

  • Cary Cotton, MD, MPH

    Cary Cotton, MD, MPH

  • Sonya Dasharathy, MD

    Sonya Dasharathy, MD

  • Juan D. Gomez Cifuentes, MD

    Juan D. Gomez Cifuentes, MD

  • Shida Haghighat, MD

    Shida Haghighat, MD

  • Avni Jain, MD

    Avni Jain, MD

  • Daniel Lew, MD

    Daniel Lew, MD

  • Hammad Liaquat, MD

    Hammad Liaquat, MD

  • Valentine Millien, MD

    Valentine Millien, MD

  • Sobia Mujtaba, MD

    Sobia Mujtaba, MD

  • Navine Nasser-Ghodsi, MD

    Navine Nasser-Ghodsi, MD

  • Brendon O’Connell, MD

    Brendon O’Connell, MD

  • Benjamin Robey, MD

    Benjamin Robey, MD

  • Sharmistha Rudra, MD

    Sharmistha Rudra, MD

  • Aditya Sreenivasan, MD

    Aditya Sreenivasan, MD

  • Chung Sang Tse, MD

    Chung Sang Tse, MD

Ahmad Alkaddour, MD

Augusta University

Use of Tokyo guidelines (TG-18) for acute cholangitis provides improved specificity and accuracy compared to fellow clinical assessment: A US academic center pilot study

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

A Quality Improvement Project to Improve Knowledge of the Cost of Single-Use Endoscopy Devices in a University-Based Endoscopy Center

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

Assessment of Provider and Patient Knowledge of Pneumococcal Vaccination and Barriers to Vaccination in Inflammatory Bowel Disease

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

Corneal Abrasions During Endoscopic Procedures in the Covid-19 Era are a Preventable Phenomenon: A Quality Improvement Project

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

Optimizing Colonoscopy Procedures and Reducing Patient Anxiety Through Recently Developed Online Information Resources

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

A Quality Improvement Project on the Development of an Evidence-Based Management Algorithm for Iatrogenic Endoscopic Perforations and the Long-Term Impact on Physician Knowledge

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

Impact of Epic Smartlist and Lumens Software in Improving OP-29 Compliance at a Tertiary Health Care 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

Improving Adherence to Gastric Intestinal Metaplasia Clinical Practice Guidelines Among Gastroenterologists at a U.S. Academic Institution

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 Role of a Pharmacist in Improving Vaccination Discussions and Completion in Patients with Inflammatory Bowel Disease

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

Improving Physician Documentation of Anticoagulant and Antiplatelet Recommendations After Endoscopy: A Multifaceted, Longitudinal Quality Improvement Success Story at the Durham Veterans Affairs Medical Center

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

A Simple Quality Initiative Significantly Improves Post-Procedural Documentation of an Anticoagulation Plan After Elective Endoscopy

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

Improving Influenza Vaccination in Pediatric Inflammatory Bowel Disease: A Quality Improvement Initiative

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

Reduction of Chronic Steroid Use in Patients Discharged for Inflammatory Bowel Disease Flares: A 28-Month Quality Improvement Study

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%).

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