Quality in GERD and Barrett’s Esophagus

Measuring quality in endoscopy is increasingly important to assess and enhance patient outcomes, promote efficiency and appropriate resource utilization, and create a culture of continuous improvement. This chapter explores critical aspects of quality of care in both gastroesophageal reflux disease (GERD) and Barrett’s esophagus. Patients with GERD must be evaluated for alarm systems, be considered for objective testing when present, and have their proton pump inhibitor (PPI) therapy regularly reviewed. Patients with Barrett’s esophagus, a known precursor to esophageal adenocarcinoma, should undergo endoscopic evaluation to assess for dysplasia. If dysplasia is confirmed, suspicious areas should be removed by endoscopic resection followed by complete eradication of the remaining intestinal metaplasia. Below we will review the existing literature, guidelines, recommended thresholds, and targets for quality improvement initiatives relating to all facets of care within these disease states.