Post written by Lorenzo Norsa, MD, PhD, from the Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, Milan, Italy, Salvatore Oliva, MD, PhD, from the Pediatric Gastroenterology and Liver Unit, Maternal and Child Health Department, Sapienza University of Rome, Rome, Italy, and Francesco Morotti, MD, from the Neonatology and Neonatal Intensive Care Unit, Spedali Civili Children’s Hospital, Brescia, Italy.

Definition and application of quality metrics are novel in pediatric endoscopy. Several efforts went into the development, leading to publication of a set of endoscopy quality guidelines by the joint European Society of Pediatric Gastroenterology Hepatology and Nutrition—North American Society of Paediatric Gastroenterology Hepatology and Nutrition Pediatric Endoscopy Quality Improvement Network in 2022. In the last decade, mobile technology has become a reliable, easy-to-access, and flexible assistant in the medical field.

Our study aimed to assess the level of adherence of Italian pediatric endoscopy centers to children-specific quality standards with the use of a dedicated mobile health tool.

Pediatric endoscopy must keep up with quality evaluation and benchmarking. To our knowledge, our study is the first to evaluate these issues prospectively in a large cohort of centers. An essential point of our study was to raise awareness of newly codified quality standards and their potential use in clinical practice. We also wanted to prove that mobile technology could have a positive impact, yielding a more straightforward and immediate data collection process.

This study focused on adherence to quality standards of 2654 upper endoscopy procedures performed in 24 pediatric facilities between April 2019 and March 2021. Italian centers appear to align with facility quality standards, with pediatricians involved in 95% of diagnostic and operative procedures.  Collaboration with adult gastroenterologists is good, and the transition rate to adult services is almost 100%. Procedure-specific quality metrics are usually fulfilled, and the adverse event rate corresponds with literature-derived incidence (1%).

Nevertheless, we observed a suboptimal adherence to disease-specific guidelines for biopsy number collection, a tendency not to include anesthesiologic details in the reports, and a frequent overlook of biopsy report communication details and patient satisfaction questionnaire administration. Overall, the data we gathered are an essential baseline for further evaluation of endoscopy quality in Italy.

Last but not least, our study proves that mobile technology is a precious tool for research and clinical practice. The open-access EndoPed smartphone app undoubtedly helped the survey reach a higher reporting yield from the study participants.

In the future, the EndoPed app could be a perfect companion for endoscopists willing to continuously monitor their activity and create a benchmark for further quality improvement.  

Graphical abstract

Read the full article online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.