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Sep 29, 2023, 10:22 by Sarah Moore

A gap was identified in quality of care around a safe exit from the building. The focus of our study surrounded optimal patient safety and satisfaction in relation to the discharge exit. The goal was that by the end of September there would be no more than one negative patient comment regarding unsafe exits from the building.

Sep 29, 2023, 10:13 by Sarah Moore

The practice has seen an increased percentage of “no-shows” across all physicians over the past several months. “No-show” means any patient who fails to arrive for a scheduled procedure appointment. No-shows create gaps and inefficiency in quality care, schedules and finances.

Sep 29, 2023, 10:07 by Sarah Moore

Appropriate scheduling of endoscopy patients in an ASC is critical in providing safe quality care. Rescheduling due to patient complexity is costly to the patients, families and ASC. Patients performed colon preparations, found transportation and took time off work. With limited resources that an ASC can offer, it is essential that the most appropriate care is provided to the most appropriate population.

Sep 29, 2023, 10:03 by Sarah Moore

To increase ADR while integrating AI-assisted colonoscopy into patient care.

Sep 29, 2023, 10:00 by Sarah Moore

During physician peer review meetings in January 2021, physicians reported a significant increase in incomplete and aborted colonoscopies due to suboptimal bowel cleanses in the past three months. Colonoscopy remains the standard in colon cancer screening and prevention. Inadequate colon preparation could result in poor mucosal visibility, leading to low adenoma detection rates, which could result in an increase in adenocarcinomas. The purpose of this study was to increase the quality of bowel preparation.

Sep 29, 2023, 09:57 by Sarah Moore

Sep 28, 2023, 11:46 by Sarah Moore

It was observed by the endoscopy nurse manager that the endoscopy unit staff lacked general gastroenterology knowledge due to previously working in other medical fields, thus the gap in quality care was staff being unknowledgeable. Project goal was to have 90% increase in staff knowledge.

Sep 27, 2023, 14:14 by Sarah Moore

A 28-year-old female with a history of laparoscopic cholecystectomy one year ago presents to the GI clinic for follow-up of a possible “cyst on her liver.” At the time of her cholecystectomy, an ultrasound of the gallbladder and biliary tree was performed. She recalls her surgeon recommending follow-up with a gastroenterologist for further evaluation. She is asymptomatic. Recent labs by her primary physician include a normal complete blood count and comprehensive metabolic panel. She has no known personal or family history of liver disease. She denies risk factors for viral hepatitis. She consumes four to six alcoholic beverages per week. She has hypothyroid disease that is well controlled on once daily levothyroxine. She does not take any other medications, vitamins or herbal supplements.

Sep 27, 2023, 14:13 by Sarah Moore

A 48-year-old male with a medical history for hyperlipidemia and appendectomy several years ago presents to the emergency room (ER) with a chief complaint of nausea and vomiting. The nausea and vomiting began 12 hours ago. He has had multiple episodes of nonbloody emesis. He also describes crampy abdominal pain located around the “belly button” and inability to pass gas (flatus). His only medication is atorvastatin. Physical examination reveals abdominal distention, tympany on percussion and high-pitched “tinkling” sounds on auscultation. The ER advanced practice provider-physician team suspects an acute small bowel obstruction (SBO) secondary to adhesions from his appendectomy.

Sep 27, 2023, 14:13 by Sarah Moore

A 54-year-old male with a medical history of hypertension and GERD presents to the GI clinic with a chief complaint of dysphagia for six months. It is intermittent and only to solids, most commonly when eating beef or chicken. He estimates symptoms occur one to two times per month. This has remained stable over the last six months with no progression. He denies dysphagia to liquids or soft food. He has not lost weight. He denies nausea, vomiting, melena, hematemesis or coffee ground emesis. His GERD is well controlled by 20 mg daily of omeprazole taken orally 30 minutes prior to breakfast. His hypertension is well controlled by lisinopril. He does not take any other medications, including over-the-counter products or supplements. He has no history of asthma, seasonal allergies or food allergies. There is no known family history of gastrointestinal malignancy. Nine months ago, at his annual primary care evaluation, routine lab tests were completed, including complete blood count and comprehensive metabolic panels. Results were all within normal limits. His physical examination is unremarkable. Specifically, there was no evidence of lymphadenopathy, thyromegaly, or palpable masses or tenderness in the chest or abdomen during the examination.

Sep 27, 2023, 14:13 by Sarah Moore

A 54-year-old female with a medical history significant for GERD presents to the GI clinic with a chief complaint of diarrhea. It began six weeks ago. She has four to eight watery, non-bloody bowel movements per day. The diarrhea is associated with fecal urgency and occasional nocturnal diarrhea. She has not used antibiotics recently. She has had no recent travel outside the U.S. or no known ill contacts. She does not use magnesium containing antacids or supplements and denies any recent dietary changes. She does not report consumption of sugar-free candies or diet beverages. Her GERD is well controlled with lansoprazole 30 mg once daily prior to breakfast. Over-the-counter anti-diarrheal medications did not help.

Sep 27, 2023, 14:12 by Sarah Moore

A 56-year-old male with a past medical history significant for type 2 diabetes mellitus and hypertension presents to the GI clinic with a chief complaint of abdominal pain for four days. Pain is localized to the left lower quadrant. He describes it as sharp and variable in intensity. It does not radiate. He has not had a bowel movement in 48 hours. Typically, he has a bowel movement every day.

Sep 27, 2023, 14:12 by Sarah Moore

A 40-year-old woman presented for evaluation of dysphagia. Symptoms began three years ago and recently worsened. She has dysphagia to solids and liquids with almost every meal. She describes a sensation of “food or liquids stacking up in my esophagus.” Some episodes of dysphagia are associated with mild substernal chest pressure. She will walk around, raise her chin and move her shoulders backward in an attempt to alleviate the discomfort. She has rare episodes of nocturnal oral regurgitation, denies weight loss, GI bleeding and heartburn, and does not use alcohol or tobacco. She takes levothyroxine for hypothyroidism. There is no other medical history and no family history of GI cancers. She denies seasonal allergies.

Sep 27, 2023, 14:12 by Sarah Moore

The patient is a 35-year-old Caucasian female who presents with a chief complaint of “my liver tests are abnormal.” At her annual gynecology visit, routine labs were drawn. A complete blood count (CBC) was normal. A comprehensive metabolic panel (CMP) revealed mild elevation of the aspartate aminotransferase at 52 U/L and alanine transaminase at 64 U/L. There was a significant elevation of the alkaline phosphatase at 320 U/L. The total bilirubin and albumin were normal. A CBC and CMP last done 3 years ago were normal.

Sep 27, 2023, 14:12 by Sarah Moore

A 20-year-old white female presented to the GI clinic with a chief complaint of “fatigue and low blood count.” She is an elite athlete. She runs cross country for a division 1 university. Approximately three months ago, she noted significant fatigue after training regimens. Two months ago, she noted steadily decreasing times for her cross country runs. She also noted daily fatigue unrelated to training. She has a lifelong history of constipation, having two to three bowel movements per week. Over the last two months her bowel habits have changed. She now has one to two daily, formed, non-bloody bowel movements. She denies any other symptoms. Specifically, no weight loss, no abdominal pain and no GI bleeding. She has no chronic medical problems and does not take any medication, vitamins or supplements. Evaluation by her primary physician revealed an Hgb of 10.8 and a slightly decreased mean corpuscular volume. Of note, she states her grandmother (originally from western Ireland) has some type of “GI disease.”

Sep 27, 2023, 14:12 by Sarah Moore

A 52-year-old white male presented to the emergency room (ER) with a chief complaint of “passing blood from my rectum.” The bleeding was acute in onset and began approximately 18 hours ago. He has had a total of four episodes of bright red blood per rectum. In the first two episodes, he passed a mixture of stool and blood; however, in the two most recent episodes, he passed only blood. He describes each episode as a “large amount of blood.” He has no other symptoms, including no abdominal pain. In the ER, his initial heart rate was 110, and his blood pressure was 98/64. He received one liter of normal saline with a decrease in his heart rate to the low 90s and improvement in his blood pressure to 110/70. Hemoglobin on presentation was 11.2. He had a normal complete blood count (CBC) and comprehensive metabolic panel (CMP) one year ago. The last colonoscopy was two years ago; it was negative for polyps and cancer. He was told he had “pockets” in his colon. He has well-controlled hypertension on lisinopril 20 mg po daily.

Sep 27, 2023, 14:12 by Sarah Moore

A 45-year-old Caucasian male presented to the ED with melena for 7 days. On further questioning, patient reported intermittent dyspepsia, nausea, early satiety and bloating for the prior 6 weeks. He had decreased his oral intake secondary to these symptoms and has had a 10-pound weight loss. He admits to dizziness. He denies fevers, chills, vomiting, hematemesis, jaundice.

Sep 27, 2023, 14:11 by Sarah Moore

A 45-year-old African American female presents to her gastroenterologist for an open access screening colonoscopy. Currently, she is asymptomatic. She has no known family history of colon cancer or colon polyps. This is her first colonoscopy. Past medical history includes hypertension, well-controlled on chlorthalidone. She exercises 4-5 times per week and adheres to a low-fat diet. She drinks 2-4 glasses of wine per week. She does not smoke or use recreational drugs.

Sep 27, 2023, 14:07 by Sarah Moore

The patient is a 34-year-old Caucasian female who presents with a chief complaint of “abnormal liver labs”. She states that over the last six months she has lacked energy and is easily fatigued. She’s an avid cyclist, however this has become more difficult due to fatigue. She has no other complaints. Due to the severity of fatigue and its impact on her regular activities, she went to her primary care physician. Her evaluation, including abdominal ultrasound, was negative except for a mild elevation of the AST and ALT at 72 U/L and ALT 90 U/L respectively. Her platelet count, albumin, bilirubin, and alkaline phosphatase are all normal.

May 30, 2018, 08:51 by User Not Found