PTU-59 A quality improvement project (QIP) to reduce inappropriate biopsies at endoscopy

Introduction Histopathology costs represent a significant cost for endoscopy departments. Biopsies are useful when they can influence the management of our patients. Our aim was to demonstrate that application of a biopsy protocol could reduce costs and inappropriate use of resources. Methods Analysis of 486 OGDs and 412 Colonoscopies was performed between April and May 2019. A biopsy protocol was produced using national guidelines (see Table 1). An assessment was made of the appropriateness of biopsy in each case. A price list of sample pots was obtained, and estimated costs were calculated to deduce the potential cost savings if guidelines had been adhered to over this 2-month period. Results Of the 486 OGDs performed, biopsies were taken in 185 cases, of which 131 were appropriate (71%). An estimated £1816 may have been saved from reducing inappropriate biopsies. Of the 412 Colonoscopies performed, biopsies were taken in 266 cases, of which 190 were appropriate (71%). An estimated £2555 may have been saved from reducing inappropriate biopsies over this 2-month period. reduces the number of inappropriate biopsies, pathology work-load and costs. A learning event was held to disseminate the protocol and the results of this QIP to our endoscopists. days. Conclusions These data show that a significant proportion of complex polyps may contain a cancer focus not recognised on prior endoscopy or biopsy. Polypectomy therefore should not be delayed.