Amandeep K. Shergill MD, MS , Carisa Harris-Adamson PhD, CPE
{"title":"Preface to Endoscopic Ergonomics: Problems and solutions","authors":"Amandeep K. Shergill MD, MS , Carisa Harris-Adamson PhD, CPE","doi":"10.1016/j.tgie.2019.07.003","DOIUrl":"10.1016/j.tgie.2019.07.003","url":null,"abstract":"","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2019.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45865775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Implementing ergonomics interventions in the endoscopy suite","authors":"M. Fahad Ali MD, Jason Samarasena MD, FACG","doi":"10.1016/j.tgie.2019.07.007","DOIUrl":"10.1016/j.tgie.2019.07.007","url":null,"abstract":"<div><p><span>Gastroenterologists are at risk for endoscopic- injuries due to higher endoscopic volume, repetitive movements, poor posture, and limited education on endoscopic ergonomics. Limited studies however have investigated how to best educate gastroenterologists and other staff on proper endoscopic ergonomics to help reduce endoscopic-related injuries. The following is a review of a division-wide ergonomics educational quality improvement project at our </span>endoscopy<span> center and a discussion on how to obtain buy in from key stakeholders to make meaningful long-term changes in the endoscopy unit.</span></p></div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2019.07.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48578577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Azadeh Khanicheh PhD , Amandeep K. Shergill MD, MS
{"title":"Endoscope design for the future","authors":"Azadeh Khanicheh PhD , Amandeep K. Shergill MD, MS","doi":"10.1016/j.tgie.2019.05.003","DOIUrl":"10.1016/j.tgie.2019.05.003","url":null,"abstract":"<div><p>A preponderance of evidence, primarily from surveys, has shown that gastroenterologists suffer from overuse injuries and pain of hand/fingers, wrist, forearm, shoulder, and back due to awkward postures, high forces, and repetitive movements during endoscopy<span>. Although flexible endoscopes are brilliantly designed compact instruments that include light and image guides, irrigation channels, suction channel, biopsy channels and are the result of many technological advancements and iterations in the last 5 decades, not much has changed in their basic functions, layout, ergonomic design, and usability. The required hand-tool interaction in order to maneuver the endoscope inside the intestinal lumen, such as stabilizing the control section while manipulating dials with the left hand while simultaneously torqueing, pushing, and/or pulling the insertion tube with the right hand, are still unchanged. It is imperative that the scope manufacturers understand the ergonomic areas of concern in the design of current endoscopes and incorporate ergonomic principles in future designs to optimize the interface between the instrument and the physician. In addition, it is as important for the physicians to be educated on ergonomic principles to minimize the risk for endoscopy-related injuries. This chapter reviews the design of current endoscopes and the ergonomic areas of concern. We review endoscope design changes that are needed to mitigate risk of injury during endoscopy, possible innovations that may improve endoscope ergonomics in the future, and barriers to implementation of any intervention that will address these shortcomings.</span></p></div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2019.05.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44637422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amandeep K. Shergill MD, MS , Carisa Harris Adamson PhD, CPE
{"title":"Failure of an engineered system: The gastrointestinal endoscope","authors":"Amandeep K. Shergill MD, MS , Carisa Harris Adamson PhD, CPE","doi":"10.1016/j.tgie.2019.02.001","DOIUrl":"10.1016/j.tgie.2019.02.001","url":null,"abstract":"<div><p><span>Advances in endoscopic technology continue to expand the field of gastrointestinal endoscopy. However, there have been no parallel advances in general </span>endoscope<span><span> design, and gastroenterologists are at risk for musculoskeletal repetitive strain injury due to the repetition, high forces and prolonged, awkward postures required to perform endoscopy. The current endoscope design lacks a consideration of human factors, and due to the high risk of injury, represents a failure of an engineered system. This review will focus on a risk assessment and management strategy for the gastrointestinal endoscope. Risk assessment is the identification of potential flaws in the system. Risk management describes the steps taken to mitigate these flaws. Three different approaches to risk assessment and management, proactive, reactive, and interactive risk assessment and management, will be reviewed as they apply to the performance of </span>gastrointestinal endoscopy.</span></p></div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2019.02.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44787494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nimisha K. Parekh MD, MPH, FACG, AGAF, Kenneth McQuaid
{"title":"The injured endoscopist: A roadmap for recovery","authors":"Nimisha K. Parekh MD, MPH, FACG, AGAF, Kenneth McQuaid","doi":"10.1016/j.tgie.2019.07.008","DOIUrl":"10.1016/j.tgie.2019.07.008","url":null,"abstract":"<div><p><span>Gastroenterologists are at increased risk for musculoskeletal injuries from overuse and repetitive motions during </span>endoscopy<span>. Recently there has been more awareness of ergonomics in endoscopy and strategies for improvement since an injury can be shocking to a physician's career. This article reviews common injuries seen in those who practice endoscopy, steps in managing an injury, guidelines for ergonomic design of a procedure suite, and a basic primer on disability insurance. Incorporation of ergonomic principles in the endoscopy suite and during use of electronic health record can minimize risk of work-related injuries.</span></p></div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2019.07.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48538887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Part I: How to ergonomically design a modern endoscopic suite","authors":"George Tan MD, MBA, Satish S.C. Rao MD, PhD","doi":"10.1016/j.tgie.2019.07.001","DOIUrl":"10.1016/j.tgie.2019.07.001","url":null,"abstract":"<div><p>The endoscopy<span><span> suite is the central hub of activity where most gastroenterologists spend a majority of their time in clinical practice. With the evolution of more complex diagnostic and therapeutic procedures, an ergonomically designed and dedicated gastrointestinal endoscopic unit is not only desirable but a necessity. Such a unit will ensure optimal workflow efficiency and throughput, as well as both patient and physician safety. It is important to plan meticulously upfront by seeking input from all stakeholders including engineers, physicians, nurses, technicians and architects. This will ensure a highly desirable work environment including procedural areas and the scope cleaning/sterilization section while optimizing patient and instrument flow. The procedure room should be ergonomically designed to allow for adjustability and optimize utilization of space for endoscopists, technicians, nurses, anesthesiologists, and trainees as well as the equipment required to perform the endoscopic procedures. This article provides practical tips on how to plan and develop an endoscopy suite, taking into consideration ergonomic and regulatory aspects, and is based on real life experience with designing a modern </span>gastroenterology procedural suite.</span></p></div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2019.07.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43989757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Roy Soetikno MD, MS , Ravishankar Asokkumar MBBS, MRCP , Tiffany Nguyen-Vu BA , Thomas DeSimio RN , Tonya Kaltenbach MD, MS
{"title":"Holding and manipulating the endoscope: A user's guide","authors":"Roy Soetikno MD, MS , Ravishankar Asokkumar MBBS, MRCP , Tiffany Nguyen-Vu BA , Thomas DeSimio RN , Tonya Kaltenbach MD, MS","doi":"10.1016/j.tgie.2019.07.006","DOIUrl":"10.1016/j.tgie.2019.07.006","url":null,"abstract":"<div><p>The way endoscopists hold and manipulate the endoscope<span> during examination varies. The lack of a standard manual on how to hold and manipulate the endoscope has perhaps contributed to the variation seen in practice. Unfortunately, the knowledge of how to properly hold the endoscope is not innate. What seems to be the simplest form may actually be incorrect. Developing the ability to hold and to manipulate the endoscope correctly requires practice and time. We are very pleased to contribute to this chapter given the paucity of literature and the importance of this foundational technique when performing endoscopy.</span></p></div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2019.07.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44517383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kerstin Austin MD, Haley Schoenberger MD, Sumona Saha MD, MS
{"title":"Special situations: Performance of endoscopy while pregnant","authors":"Kerstin Austin MD, Haley Schoenberger MD, Sumona Saha MD, MS","doi":"10.1016/j.tgie.2019.06.001","DOIUrl":"10.1016/j.tgie.2019.06.001","url":null,"abstract":"<div><p>The rates of women entering the field of gastroenterology<span> have been increasing over the past several years. Most of these women enter the field during childbearing years. At the same time, the procedural demands placed on endoscopists have been increasing as well. With these changes in demographics to the physicians performing endoscopy, more attention should be paid to the physical demands of scoping while pregnant. In this paper, we focus on several common, overlapping injuries that are frequently encountered during pregnancy and while performing endoscopy. Additionally, ergonomic modifications and strategies are outlined for both the pregnant and postpartum endoscopist. Given the lack of data in this area, dedicated studies aimed at this specific population would help guide further recommendations.</span></p></div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2019.06.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46540190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Avoiding burnout: A gastroenterologist's toolbox","authors":"Ronak V. Patel MD, Rajesh Keswani MD","doi":"10.1016/j.tgie.2019.07.004","DOIUrl":"10.1016/j.tgie.2019.07.004","url":null,"abstract":"<div><p>Physician burnout is an increasingly recognized syndrome which not only negatively affects physicians but has a detrimental impact on the overall healthcare system; similar to other physicians, gastroenterologists are susceptible to burnout due to multiple competing responsibilities. Avoiding and treating burnout must utilize a multifaceted approach to enhance recognition among physicians and peers, identify triggers and potential solutions, promote optimal coping mechanisms, and correct systemic issues. While as a medical community we have raised awareness regarding burnout, continued efforts are needed to develop modalities to prevent and mitigate burnout.</p></div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2019.07.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55156181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Part II: Optimizing endoscopy unit design: Lessons from a modern endoscopy suite in Japan","authors":"Shinji Tanaka MD, PhD, FASGE, FACG , Gottumukkala S. Raju MD, FASGE","doi":"10.1016/j.tgie.2019.07.005","DOIUrl":"10.1016/j.tgie.2019.07.005","url":null,"abstract":"<div><p>During a visit to the Hiroshima University Hospital in April of 2018, an endoscopist (GSR) observed and learned several facets from an ergonomically designed endoscopy unit which opened its doors to service in 2013. This review is a reflection of those observations during that visit, which might be helpful to a Western endoscopist.</p></div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2019.07.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43846164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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