How do you log your GI procedure?

[browngastro]

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Our program is trying to find a new way for fellows to log their GI procedures because our current system is designed over a decade ago.

I appreciate if you can fill out the survey. Only 5 questions. Should take less than 30 seconds. Thanks a lot.

GI Procedure Log

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[cabergoline2]

bro , we export data from provation in spreadsheet and manually add some information like stents placed , clips put , polyps removed etc... so its partly exported data from provation , partly manual.. kudos and doing this as qi project... all of us need a lot of kicks in the behind by attending to make sure logs are accurate..

 

[browngastro]

First of all, a sincere thank to the few of you who filled in the survey.

So far, we have 3 votes for New Innovation, 2 votes for AGA Procedure Log, 2 votes for Export from ProVation, and 3 for Others.

I will continue post the results as more people fill in the survey. Hopefully, someone else who find this data useful as well.


If you haven't complete the survey yet, please take a moment to help us out. It only takes 30 seconds, thank you very much for your help.

@cabergoline2. Thank you very much for your response. I agree that exporting from ProVation is a way to go, but I am hoping we can do better. I imagine we can have a tool that can also help with generating path reports (or at least reminding us to review the path report), sending follow-up procedure reminders (e.g. for repeat colonoscopies or stent pull), etc.

We will keep you guys posted. Thank you.

 

[cabergoline2]

First of all, a sincere thank to the few of you who filled in the survey.

So far, we have 3 votes for New Innovation, 2 votes for AGA Procedure Log, 2 votes for Export from ProVation, and 3 for Others.

I will continue post the results as more people fill in the survey. Hopefully, someone else who find this data useful as well.


If you haven't complete the survey yet, please take a moment to help us out. It only takes 30 seconds, thank you very much for your help.

@cabergoline2. Thank you very much for your response. I agree that exporting from ProVation is a way to go, but I am hoping we can do better. I imagine we can have a tool that can also help with generating path reports (or at least reminding us to review the path report), sending follow-up procedure reminders (e.g. for repeat colonoscopies or stent pull), etc.

We will keep you guys posted. Thank you.

How do you keep up with Path reports ? I imagine you come from a endoscopically busy program yourself. Following path report and communicating with patients is a very omission and error prone area. thankfully , neither me nor my cofellows have missed communicating something as critical as cancer. (the 2-3 cancers I diagnose every week I am on top of them). But it has happened to me and all fellows that relatively minor stuff like + H.pylori gets missed. Particularly happens in inpatient scopes that get discharged , as also some outpatient scopes. I try to schedule follow up appointments of all my scopes just to make sure we don't miss communicating stuff..this leads to OP patient visits that are not necessary...and there are always no shows in those kind of appointments..

How is your experience ? do you guys sometimes miss communicating stuff like h.pylori + or miss seeing biopsy results if they don't end up in your epic mailbox (happens a lot here)..

Further , do you guys use the ProVation query tool ?

 

[hemosuccus]

How do you keep up with Path reports ? I imagine you come from a endoscopically busy program yourself. Following path report and communicating with patients is a very omission and error prone area. thankfully , neither me nor my cofellows have missed communicating something as critical as cancer. (the 2-3 cancers I diagnose every week I am on top of them). But it has happened to me and all fellows that relatively minor stuff like + H.pylori gets missed. Particularly happens in inpatient scopes that get discharged , as also some outpatient scopes. I try to schedule follow up appointments of all my scopes just to make sure we don't miss communicating stuff..this leads to OP patient visits that are not necessary...and there are always no shows in those kind of appointments..

How is your experience ? do you guys sometimes miss communicating stuff like h.pylori + or miss seeing biopsy results if they don't end up in your epic mailbox (happens a lot here)..

Further , do you guys use the ProVation query tool ?

I am surprised programs leave this to you, that is a systems issue. This should NOT be the fellows responsibility, missing any path is a critical design flaw. All path is ultimately the responsibility of the attendings and there should be (multiple) redundancies in place for this, on the fellows side, nurses (should have someone assigned to monitor) and attendings

 

[cabergoline2]

I am surprised programs leave this to you, that is a systems issue. This should NOT be the fellows responsibility, missing any path is a critical design flaw. All path is ultimately the responsibility of the attendings and there should be (multiple) redundancies in place for this, on the fellows side, nurses (should have someone assigned to monitor) and attendings

how is it in your program ? do you guys have nurses /midlevels monitoring this as well? do you guys get Epic messages for path results? does lab call/page you with critical results (like cancer , dysplasia in UC etc) ? what are the layers of redundancy in your place?

Here it is fellow and attending only... it is indeed a systems issue here and we are trying to figure out a solutions...

 

[hemosuccus]

how is it in your program ? do you guys have nurses /midlevels monitoring this as well? do you guys get Epic messages for path results? does lab call/page you with critical results (like cancer , dysplasia in UC etc) ? what are the layers of redundancy in your place?

Here it is fellow and attending only... it is indeed a systems issue here and we are trying to figure out a solutions...

Epic inbox message to the fellows pool, who the path, attendings get a separate list they are supposed to double check, and I believe there's an admin person who also double checks after a specific time limit that a path letter was generated. Pathologists will page about cancer but not usually anything else. The VAs I have trained at have their own similar formal system and specific path latter generated

 

[browngastro]

How do you keep up with Path reports ? I imagine you come from a endoscopically busy program yourself. Following path report and communicating with patients is a very omission and error prone area. thankfully , neither me nor my cofellows have missed communicating something as critical as cancer. (the 2-3 cancers I diagnose every week I am on top of them). But it has happened to me and all fellows that relatively minor stuff like + H.pylori gets missed. Particularly happens in inpatient scopes that get discharged , as also some outpatient scopes. I try to schedule follow up appointments of all my scopes just to make sure we don't miss communicating stuff..this leads to OP patient visits that are not necessary...and there are always no shows in those kind of appointments..

How is your experience ? do you guys sometimes miss communicating stuff like h.pylori + or miss seeing biopsy results if they don't end up in your epic mailbox (happens a lot here)..

Further , do you guys use the ProVation query tool ?

In our program, the responsibility of following up on path falls on the fellows as well. Both the fellow who did the scope as well as the fellow how owns the patient get a copy the path report. A third copy is sent to the attending who supervised the scope. We also get notified for cancers and other critical findings.

Personally, I also try to schedule a clinic follow-up soon after the procedure. I don't think it's necessarily a waste of time since patients often appreciate being able to see the images and have the opportunity to ask questions.

Thanks again for your feedback.

Everyone, please take a moment to fill in the survey. Thank you.

 

[indonacious]

We use proc tracker which is terrible but I’ve independently been using provation export. Only issue with provation export is that if you don’t do the report, you rely on others adding your name as a provider for it to show up on query. Assuming this doesn’t happen each time, could lead to underestimate.

Unrelatedly, how many EGD/colons are most of you doing in the covid era?

in regards to path, fellow and attending are both sent and often varies who follows up on it.

 

[cabergoline2]

We use proc tracker which is terrible but I’ve independently been using provation export. Only issue with provation export is that if you don’t do the report, you rely on others adding your name as a provider for it to show up on query. Assuming this doesn’t happen each time, could lead to underestimate.

Unrelatedly, how many EGD/colons are most of you doing in the covid era?

in regards to path, fellow and attending are both sent and often varies who follows up on it.

I am a 2nd year fellow . So far I ve done 700 EGDs , 200+ colons , ... we suffered a lot from screening colonoscopy perspective...