– Canada’s gastroenterologists have new guidelines on safety and quality indicators to help with the more than 1.6 million procedures performed each year, their association announced Monday. Although the Canadian Association of Gastroenterology has guidelines around credentials and training, there was a void in other areas. “If one looks at the sort of totality of endoscopy service delivery, particularly from a patient point of view — which is access to services, rapid access, high quality services, feedback, and an ability to respond to how they perceive endoscopy service delivery — then there really was nothing in place,” said Dr. David Armstrong, chair of the endoscopy committee and the consensus guideline committee. Endoscopy is used to detect or screen for a number of diseases and involves examining the colon or digestive tract using a long, thin tube with a light and camera attached. Last October, about 6,800 Ottawa residents were sent letters from public health officials after it was found that a non-hospital clinic wasn’t following some procedures involving cleaning and infection prevention. The letters indicated the patients might have been exposed to hepatitis B, hepatitis C or HIV. Armstrong said he likes to think the presence of these guidelines would have made a difference in the Ottawa situation. “That’s really because one of the challenges for endoscopy — and it’s in and out of hospitals — has been that if there isn’t a framework to say how things should be monitored and how they should be delivered, it’s difficult to know how much or how closely to monitor things, and what actually are the standards,” Armstrong said in an interview from Hamilton, where he’s an associate professor of medicine at McMaster University. “So I think guidelines that say what should be monitored and what processes have to be in place really from a patient point of view and knowledge that there are tools available to monitor the way that services are delivered and to use as a basis for quality improvement programs would have made a big difference.” Armstrong indicated that it used to be felt that washing the scope and then doing a manual cleaning was sufficient. “And the trouble is there are times when that isn’t sufficient. It’s also important to ensure that all of the endoscopy manufacturers’ instructions and the automatic cleaning equipment instructions are followed, that there’s regular checks of the equipment and the water supply and the filtration and everything else.” It’s something of an undertaking, he noted. “And so to know that those have to be checked regularly and incorporated into all the other quality processes, I think is going to be key as we go forward — particularly as volumes increase.” The new Consensus Guidelines on Safety and Quality Indicators in Endoscopy were developed by a group of 35 Canadian, European and U.S.-based participants, the association said. They reviewed more than two decades’ worth of research to develop their recommendations.
The Great Canadian Fart Survey
Meanwhile, Canadians have told Statistics Canada that waiting lists and wait times rank among their top health concerns. Despite the harsh realities surrounding digestive disease, Canadians must wait an inordinate amount of time for gastro-intestinal consultations and access to specialized testing. Case in point: 25% of patients with alarm symptoms, indicators of disease such as cancer, are forced to wait 4 months before their case is seen by a specialist. That’s far longer than the 3 weeks Canadians have told us that they’re willing to wait. Frankly, four months is unacceptable. It is time we got our priorities straight. Surprisingly, in developing its wait list reform of the Canadian health care system, Paul Martin’s government overlooked digestive disease. The Canadian Association of Gastroenterology has sent a call to action to Prime Minister Paul Martin, urging him to include digestive disease as a health-care priority and ensure Canadian patients obtain necessary and timely access to our specialists. Canadian gastroenterologists are already out of the starting block. The Canadian Association of Gastroenterology has done its homework, talked to patients, and is now armed with information that will be crucial in improving the Canadian health care system. We have developed 24 recommended targets for medically-acceptable wait times for gastroenterology, based on a study conducted by nearly 200 Canadian GI specialists who captured data on 5,500 patient visits. We are ready to work with Canadians to make Paul Martin’s government pay attention. We are not looking for handouts. The simple infusion of federal dollars into the health care system is a band-aid solution. We must now go further, as a society. The Canadian Association of Gastroenterology proposes to work hand-in-hand with Paul Martin’s government to develop the creative strategies that will finally allow us to bring wait times to acceptable levels.
Canadian Association of Gastroenterology: Open Letter to Canadians
Each day I was pampered on Holland America’s ship, the Ryndham. Then a stay in Rio de Janeiro strolling Copacabana’s magnificent beach. One doesn’t forget the bikini-clad Latin ladies! So still in a vacation mood I’ve searched hard and long for a lighter topic for this week’s column. I finally found The Great Canadian Fart Survey. This study will never be nominated for a Nobel Prize. It’s certainly not a topic for a sedate dinner party. But there are some amazing facts suitable for Trivial Pursuit. Besides the problem is universal. Kings, Queens and the rest of us are all affected by it. So what did the report prove. I have to be cautious on this one as I have no intention of offending any province.