Portuguese Society of Digestive Endoscopy (SPED)www.sped.pt

SPED Quality Committee

Since its foundation in 1979, quality in digestive endoscopy is a pillar of the Portuguese Society of Digestive Endoscopy (SPED), this aim being reflected in its statutes and implemented by successive governing boards year after year.

This commitment can be evidenced by a pioneer publication by SPED in 2008 named “Quality assessment and quality assurance standards for digestive endoscopy in Portugal” and the organization of several quality endoscopy meetings on a national level like “Quality on digestive endoscopy: concepts, practices and challenges” in 2013, “Quality in colonoscopy” in 2014 or the upcoming “Quality in Upper Digestive Endoscopy” to be held in the 21^st September 2018 ([Fig. 1]).

Fig. 1 2018 Quality in Upper Digestive Endoscopy meeting programme

This next meeting will be an update on all guidelines related to upper digestive endoscopy recently published by the European Society of Digestive Endoscopy (ESGE), including new performance measures suggested in the 2016 ESGE publication on “Performance measures for upper gastrointestinal endoscopy” [1]. This full day meeting will have presentations on issues like “How to translate to clinical practice, quality in information and preparation, how to increase quality, how to report, how SPED wants to implement quality in Portugal, quality in daily routine and quality in the emergency setting”.

In 2015, SPED created a committee specifically dedicated to quality issues – the Quality Committee of SPED, which intends to promote further quality implementation in Portugal, beyond meetings. At first, questionnaires were sent in 2016 to endoscopic practitioners and reporting software companies to have a picture of the real practice and to identify eventual obstacles for quality implementation in endoscopy in Portugal. Those questionnaires, available online in Portuguese at the SPED website, concluded for example, that from 2006 to 2016 high definition scopes availability increased from 0 % to 52 %, automated disinfection improved from 7 % to 90 % and that reporting software is was present in 90 % of the endoscopic services that responded. On the other hand, the reporting software available only allows the reporting in individualized fields of the duration of the exam in 33 % of cases, the use of a standardized bowel preparation scale in 22 % or definition of the level reached in 83 %. Some of the SPED Quality Committee members are also members of some ESGE Quality Committees, further linking both our Societies’ initiatives [2].

As so, the endoscopic reporting software has become a priority for the Quality Committee of SPED that is working with all available companies to improve the software's capacity of including quality parameters, according to the ESGE guidelines [3]. This will hopefully translate in automated quality indicators that endoscopic units can assess and evaluate instantly, on a personal or institutional basis. SPED aims at offering a “Quality Certificate” for those companies that demonstrate to provide endoscopic reporting software that comply with SPED and ESGE demands, “certifying” these software in quality terms and helping SPED members to better choose in a strategic decision that many times involves a relevant investment.

Moreover, quality and safety are complementary in all endoscopic performances and a security checklist was developed by SPED, provided by mail for all SPED members and available online, which is already incorporated in some of the endoscopic software.

Finally, this quality promotion seems to be stimulating individual endoscopists and endoscopic departments in the evaluation and reporting of their quality scores, translated in the recent increase of publications on this issue [4] [5] [6].

On behalf of the Quality Committee of SPED

Areia M, Eliseu L, Lopes L, Brandão C, Amaro P, Freire R, Dinis-Ribeiro M

• References

• 1 Bisschops R, Areia M, Coron E. et al. Performance measures for upper gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy 2016; 48: 843-864
• 2 Rutter MD, Senore C, Bisschops R. et al. The European Society of Gastrointestinal Endoscopy Quality Improvement Initiative: developing performance measures. Endoscopy 2016; 48: 81-89
• 3 Bretthauer M, Aabakken L, Dekker E. et al. Requirements and standards facilitating quality improvement for reporting systems in gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2016; 48: 291-294
• 4 Oliveira Ferreira A, Fidalgo C, Palmela C. et al. Adenoma Detection Rate: I Will Show You Mine if You Show Me Yours. GE Port J Gastroenterol 2017; 24: 61-67
• 5 Taveira F, Areia M, Elvas L. et al. Quality in Colonoscopy: Beyond the Adenoma Detection Rate Fever. GE Port J Gastroenterol 2017; 24: 211-218
• 6 Lisboa-Gonçalves P, Libânio D, Marques-Antunes J. et al. Quality of Reporting in Upper Gastrointestinal Endoscopy: Effect of a Simple Audit Intervention. GE Port. J Gastroenterol 2018; DOI: 10.1159/000487145.