A Quality Improvement Initiative Results in Improved Rates of Timely Postvariceal Bleeding Surveillance Endoscopy

Am J Gastroenterol. 2020 Apr;115(4):625-628. doi: 10.14309/ajg.0000000000000577.


Objectives: We performed a study to assess the effects of a quality improvement (QI) initiative on the rates of postvariceal bleeding surveillance upper endoscopy (EGD).

Methods: We identified patients with cirrhosis hospitalized with variceal bleeding and assessed the rates of timely (≤4 weeks) EGD before and after a QI initiative.

Results: Preintervention: 16% (5 of 32) of patients underwent timely surveillance EGD. We developed a standardized ordering template for gastroenterology fellows and reserved postvariceal EGD scheduling slots. Postintervention: 43% (12 of 28) of patients underwent timely surveillance EGD.

Discussion: A QI intervention was associated with a 27% absolute increase in timely surveillance EGDs.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Endoscopy, Digestive System / methods*
  • Esophageal and Gastric Varices / diagnosis*
  • Esophageal and Gastric Varices / etiology*
  • Humans
  • Liver Cirrhosis / complications*
  • North Carolina
  • Population Surveillance
  • Quality Improvement*