BOOK
Quality Colonoscopy, An Issue of Gastrointestinal Endoscopy Clinics - E-Book
(2010)
Additional Information
Book Details
Abstract
Dr. Allen’s issue focuses on how gastroenterologists can maximize the “value of colonoscopy – where value is defined as quality/cost. Clinical issues are covered, like sedation issues, complications of colonoscopy, and infection risk, but the majority of the articles deal with the discussions that surround quality colonoscopy—articles like: Risk Management and Legal Issues for Colonoscopy; Cost effectiveness of Colonoscopy in Prevention of Colon Cancer; Efficacy and Effectiveness of Colonoscopy: How Do We Bridge the Gap?; Current State of Colonoscopy Performance Measures; Use of Databases and Registries to Enhance Quality; and Maximizing the Value of Colonoscopy in Community, to name a few. In preparation of the changing landscape of healthcare, this issue will be an important one for all practicing gastroenterologists.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Contributors | iii | ||
| Contents | vii | ||
| FORTHCOMING ISSUES | xi | ||
| RECENT ISSUES | xi | ||
| Foreword | xiii | ||
| Preface | xv | ||
| Chapter 1. Risk Management and Legal Issues for Colonoscopy | 593 | ||
| RISK MANAGEMENT | 594 | ||
| SPECIFIC ISSUES IN RISK MANAGEMENT FOR QUALITY COLONOSCOPY | 595 | ||
| RISK MANAGEMENT PROGRAM | 599 | ||
| SUMMARY | 600 | ||
| REFERENCES | 600 | ||
| Chapter 2. Reducing Infection Risk in Colonoscopy | 603 | ||
| POTENTIAL INFECTION RISKS DURING COLONOSCOPY | 603 | ||
| MECHANISM OF TRANSMISSION AND LEVEL OF RISK | 605 | ||
| SPECIFIC STEPS AND METHODS TO REDUCE INFECTION RISK IN THE ENDOSCOPY UNIT | 608 | ||
| RELATED ISSUES IN REPROCESSING | 611 | ||
| REQUIREMENTS FOR THE AMBULATORY SURGERY CENTER, OFFICE ENDOSCOPY, AND HOSPITAL ENDOSCOPY UNIT: DOCUMENTATION AND QUALITY ASSURANCE | 611 | ||
| SUMMARY | 612 | ||
| REFERENCES | 612 | ||
| Chapter 3. Sedation Issues in Quality Colonoscopy | 615 | ||
| SEDATION FOR COLONOSCOPY: AN INTERNATIONAL PERSPECTIVE | 615 | ||
| THE ECONOMIC IMPLICATIONS OF SEDATION | 616 | ||
| SEDATION AND THE QUALITY OF COLONOSCOPY | 619 | ||
| DOES SEDATION IMPROVE PATIENT SATISFACTION? | 621 | ||
| SEDATION AND THE RISK OF COMPLICATIONS DURING COLONOSCOPY | 623 | ||
| SUMMARY | 624 | ||
| REFERENCES | 624 | ||
| Chapter 4. Management of High-Risk Colonoscopy Patients | 629 | ||
| MANAGEMENT OF INDIVIDUALS WITH THE LYNCH SYNDROME (HEREDITARY NONPOLYPOSIS COLORECTAL CANCER) | 630 | ||
| MANAGEMENT OF INDIVIDUALS WITH FAMILIAL ADENOMATOUS POLYPOSIS | 634 | ||
| MANAGEMENT OF INDIVIDUALS WITH OTHER POLYPOSIS SYNDROMES | 635 | ||
| MANAGMENT OF INDIVIDUALS WITH INFLAMMATORY BOWEL DISEASE | 635 | ||
| REFERENCES | 638 | ||
| Chapter 5. Maximizing the Value of the Endoscopist– Pathologist Partnership in the Management of Colorectal Polyps and Carcinoma | 641 | ||
| CURRENT CONCEPTS OF THE PATHOLOGY OF COLON POLYPS AND CANCERS | 644 | ||
| CONVENTIONAL ADENOMAS (CIMPL–, PREDOMINANTLY APC MUTATED) | 645 | ||
| SERRATED POLYPS OF THE LARGE INTESTINE (HYPERPLASTIC POLYPS AND SERRATED ADENOMAS) | 649 | ||
| RECOMMENDED SURVEILLANCE INTERVALS FOR SESSILE SERRATED ADENOMAS | 652 | ||
| INVASIVE CARCINOMA IN ADENOMA | 653 | ||
| LYNCH SYNDROME AND MSI TESTING | 654 | ||
| REFERENCES | 655 | ||
| Chapter 6. Complications of Colonoscopy: Magnitude and Management | 659 | ||
| SERIOUS GASTROINTESTINAL COLONOSCOPY COMPLICATIONS | 659 | ||
| LESS SEVERE ADVERSE EVENTS | 660 | ||
| SEDATION-RELATED AND CARDIOVASCULAR COMPLICATIONS | 660 | ||
| COMPLICATIONS RELATED TO BOWEL PREPARATION | 662 | ||
| MISCELLANEOUS COMPLICATIONS | 663 | ||
| RISK FACTORS FOR SERIOUS COLONOSCOPY COMPLICATIONS | 663 | ||
| PREVENTION OF COMPLICATIONS | 664 | ||
| MANAGEMENT OF COMPLICATIONS | 665 | ||
| SUMMARY | 666 | ||
| REFERENCES | 667 | ||
| Chapter 7. Efficacy and Effectiveness of Colonoscopy: How Do We Bridge the Gap? | 673 | ||
| THE EFFICACY OF COLONOSCOPY FOR ADENOMA DETECTION | 674 | ||
| FACTORS LIMITING THE EFFECTIVENESS OF COLONOSCOPY | 674 | ||
| DEFINING THE TRUE EFFICACY OF COLONOSCOPY | 676 | ||
| BRIDGING THE GAP: IMPROVING THE EFFECTIVENESS OF COLONOSCOPY | 678 | ||
| SUMMARY | 679 | ||
| REFERENCES | 679 | ||
| Chapter 8. Colonoscopy Reports and Current State of Performance Measures | 685 | ||
| COLONOSCOPY REPORTS | 685 | ||
| PERFORMANCE MEASURES | 689 | ||
| SUMMARY | 695 | ||
| REFERENCES | 695 | ||
| Chapter 9. Advanced Systems to Assess Colonoscopy | 699 | ||
| INTRODUCTION: PREVENTION OF COLORECTAL CANCER BY COLONOSCOPY | 699 | ||
| THE PROBLEM WITH COLONOSCOPY: NOT ALL COLORECTAL CANCERS ARE PREVENTED | 699 | ||
| ASSUMPTIONS: FACTORS THAT MAY EXPLAIN FAILURES OF COLONOSCOPY | 700 | ||
| DEFINING QUALITY OF COLONOSCOPY | 700 | ||
| ENDOSCOPIC MULTIMEDIA INFORMATION SYSTEM | 704 | ||
| EMIS RESULTS | 709 | ||
| FUTURE PLANS | 713 | ||
| SUMMARY | 715 | ||
| ACKNOWLEDGMENTS | 715 | ||
| REFERENCES | 715 | ||
| Chapter 10. The Use of Databases and Registries to Enhance Colonoscopy Quality | 717 | ||
| THE USE OF LARGE DATABASES TO ENHANCE QUALITY: THE NATIONAL HEALTHCARE QUALITY REPORT EXAMPLE | 718 | ||
| CHALLENGES IN THE USE OF ADMINISTRATIVE DATA | 719 | ||
| USING ADMINISTRATIVE DATA FOR MEASUREMENT OF INDIVIDUAL PHYSICIAN QUALITY OF CARE: THE CENTERS FOR MEDICARE AND MEDICAID SERVICES EXAMPLE | 723 | ||
| COMPLETENESS AND ACCURACY OF DATA IN CLINICAL REGISTRIES | 724 | ||
| USING ELECTRONIC HEALTH RECORD DATABASES TO ENHANCE QUALITY | 727 | ||
| ELECTRONIC REPORTING SOFTWARE FOR GASTROINTESTINAL ENDOSCOPY: THE CLINICAL OUTCOMES RESEARCH INITIATIVE EXPERIENCE | 729 | ||
| CURRENT CHALLENGES IN THE USE OF EHR DATA FOR ENHANCING QUALITY | 730 | ||
| SUMMARY | 730 | ||
| REFERENCES | 731 | ||
| Chapter 11. Defining an Episode of Care for Colonoscopy: Work of the High Value Health Care Project Characterizing Episodes and Costs of Care | 735 | ||
| MEASURING RESOURCE USE AND COSTS OF CARE | 737 | ||
| BUILDING AN EPISODE OF CARE FOR COLONOSCOPY | 738 | ||
| COLONOSCOPY EPISODE-OF-CARE COHORT DEFINITION | 739 | ||
| CAPTURING RESOURCE USE RELATED TO COLONOSCOPY | 742 | ||
| RESULTS | 743 | ||
| DISCUSSION | 746 | ||
| SUMMARY | 748 | ||
| ACKNOWLEDGMENTS | 748 | ||
| REFERENCES | 749 | ||
| Chapter 12. Cost-effectiveness of Colonoscopy | 751 | ||
| RECOMMENDATIONS FOR CRC SCREENING FROM 3 ORGANIZATIONS | 752 | ||
| COMPARATIVE EFFECTIVENESS RESEARCH TO COMPARE CRC SCREENING TESTS | 753 | ||
| MICROSIMULATION MODELING TO INFORM HEALTH POLICY | 754 | ||
| STUDY POPULATION | 755 | ||
| TEST STRATEGIES | 755 | ||
| CRC SCREENING TEST CHARACTERISTICS | 756 | ||
| COSTS | 756 | ||
| CEA | 760 | ||
| LIMITATIONS OF COST ESTIMATES | 764 | ||
| SENSITIVITY ANALYSIS | 764 | ||
| COST-EFFECTIVENESS SUMMARY | 764 | ||
| DO WE ACHIEVE THESE BENCHMARKS IN COMMUNITY PRACTICE? | 764 | ||
| CURRENT SCREENING GUIDELINES: DIFFERENCES AND COST IMPLICATIONS | 765 | ||
| REFERENCES | 766 | ||
| Chapter 13. Maximizing the Value of Colonoscopy in Community Practice | 771 | ||
| HEALTH VALUE = QUALITY/COST | 771 | ||
| HISTORICAL CONSIDERATIONS OF SCREENING COLONOSCOPY | 772 | ||
| QUALITY ISSUES FOR COLONOSCOPY IN 2010 | 772 | ||
| COST ISSUES IN COLONOSCOPY IN 2010 | 773 | ||
| ALTERNATIVE APPROACHES TO ENHANCING VALUE OF COLONOSCOPY | 776 | ||
| PRACTICE LEVEL QUALITY AND PRICE TRANSPARENCY | 776 | ||
| STATE INITIATIVES | 778 | ||
| BUNDLED PAYMENT METHODOLOGIES | 779 | ||
| DIGESTIVE HEALTH OUTCOMES REGISTRY | 779 | ||
| SUMMARY | 780 | ||
| REFERENCES | 780 | ||
| Index | 783 |