P1201 - Streamlining Video Capsule Endoscopies: An Expanded Quality Improvement Pilot Study

Jeff Angelo Taclob, MD¹, Andrew Ortega, MD², Bhavi Trivedi, MD¹, Brian Lee, DO¹, Ammar Kalas, MD², Luis Chavez, MD¹, Jose Sotelo, MD¹, Marc Zuckerman, MD¹, Ricardo Badillo, MD^1
1Texas Tech University Health Sciences Center, El Paso, TX; ²Texas Tech, El Paso, TX

Introduction: Video capsule endoscopy (VCE) is a non-invasive technology that provides diagnostic imaging of the gastrointestinal (GI) tract. Prompt diagnosis and subsequent management of abnormal VCE findings are essential to providing expedited patient care. Delays in image capture, image reading, and busy workloads may postpone healthcare delivery and increase the length of stay (LOS) and costs. Due to subjective reports of delays in VCE result reporting in our facility, we aimed to identify areas for improvement in VCE use and reporting; and thereby, implement a quality improvement (QI) intervention using visual aids and staff education to deliver timely VCE processing and reporting. Expanding on our prior research, more data was collected and reviewed.

Methods: A retrospective review of inpatient VCE revealed only 36% of inpatient VCE reports were finalized one day after capsule deployment thought to be due to miscommunication between fellows and staff regarding VCE timing. An intervention was implemented consisting of a nurse compiling a list of all deployed VCEs by the end of the deployment day. Using visual aids on our procedure board, a separate nurse was tasked to upload the VCE study by the following morning. With the visual aids, the fellow and faculty were notified to finalize the report the following day. We compared the time difference between the stages of VCE processing pre and post-intervention. We expanded our data to include more patients for the study.

Results: 76 admitted patients underwent inpatient VCE (04/2020 - 01/2023). 50 patients were categorized into pre-intervention, and 25 were categorized into post-intervention (Table 1). Pre-intervention, 18/50 (36%) VCEs were finalized one day after deployment, with a mean number of days from deployment to note finalization of 4.56 days. Post-intervention, 21/25 (84%) VCEs report finalization improved to 1.68 days. The difference in time from deployment to fellow interpretation improved from 2.3 to 0.84 days, and the difference from fellow to attending report finalization was improved from 2.26 to 0.84 days. Analysis revealed an improving trend toward clinical significance.

Discussion: VCE is an invaluable tool for a practicing gastroenterologist, however, timely interpretation of the results is essential to improve patient care and decrease associated costs. Our expanded QI intervention targeting VCE readings successfully improved the turnover of VCE reads during an inpatient admission by several days.


Disclosures:


Jeff Angelo Taclob, MD¹, Andrew Ortega, MD², Bhavi Trivedi, MD¹, Brian Lee, DO¹, Ammar Kalas, MD², Luis Chavez, MD¹, Jose Sotelo, MD¹, Marc Zuckerman, MD¹, Ricardo Badillo, MD¹. P1201 - Streamlining Video Capsule Endoscopies: An Expanded Quality Improvement Pilot Study, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.