Quality Improvement Projects

Current QI Projects

  • Assessing adherence to USMSTF guidelines for surveillance colonoscopy
    • Faculty mentor: Aparajita Singh, Najwa El-nachefDaniel Selvig
    • The US Multi-Society Taskforce updated their guidelines on appropriate interval for follow-up after colonoscopy with or without polypectomy in February 2020. A salient change is the lengthening of surveillance intervals for 1-2 adenomas <10mm to 7-10 years instead of 5-10 years. The goal of this project is to improve overall adherence to the new guidelines for pts with 1-2 diminutive TAs.
    • Selected as GI fellowship incentive project for 2020-2021 through the GME REFLECT program
  • Assessing adherence to AASLD guidelines for esophageal varices
    • Faculty mentor: Danielle Brandman, Courtney Sherman, Aparajita Singh
    • There is significant practice variation regarding recommended follow-up interval after variceal detection on EGD. In this project, our goal is to improve adherence to EV surveillance recommendations according to AASLD and ASGE guidelines. We previously developed an automated template in EndoPro to standardize guideline-based follow up recommendations.
    • Selected as the GI fellowship incentive project for 2019-2020 and met all quarterly goals
  • Improving referrals to genetic counseling for high risk GI cancer patients
    • Faculty Mentor: Aparajita Singh, Myung Ko
    • The goal of this project is to improve referral rates to genetic counseling for patients at high-risk for GI cancers.
  • Reducing inpatient stool guaiac use
    • Faculty mentor: Sara Lewin, Uma Mahadevan
    • Guaiac cards are significantly overused both in the emergency department setting as well as the inpatient setting. We aim to reduce the use of FOBT in the inpatient and emergency setting via collaboration and education of interested parties.
  • Improving bowel prep for colonoscopy
    • Faculty mentor: Kendall Beck, Aparajita Singh
    • The goal of this project is to improve the inadequate bowel prep rate at our institution. Ongoing efforts include tracking the Boston Bowel Prep Score of each colonoscopy performed at UCSF, identifying obstacles to successful bowel preparation, and optimizing bowel prep instructions for patient compliance.

Prior QI Projects

  • Reducing unnecessary EGDs for heartburn and dyspepsia
    • Faculty mentor: Priya Kathpalia
    • The goal of this project is to reduce inappropriate direct-access referrals for EGDs for dyspepsia, such as those without a prior PPI trial or non-invasive Helicobacter pylori testing. We implemented and assessed the impact of an electronic medical records-based intervention designed to encourage greater guideline adherence among referring providers.
  • Improving administration of rectal indomethacin
    • Faculty mentor: Mustafa Arain
    • Administration of rectal indomethacin has been shown to reduce the risk of post ERCP pancreatitis. The goal of this project was to increase rectal indomethacin use at our center. To do so, we performed a flow analysis to understand the process necessary to administer rectal indomethacin, and barriers to administration were identified including staff education and ease of ordering.