S2222 Measuring and Assessing ERCP Patient Outcomes Using a Power BI Dashboard

Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is a complex procedure with risk of delayed complications and morbidity. Guidelines recommend assessment of post-procedure outcomes, however these metrics are not easily obtained, and post-ERCP delayed adverse events (DAE) are likely underestimated. To address this, our institution developed a patient outcomes based ERCP quality dashboard. Methods: Data were prospectively collected for all ERCPs performed at a quaternary care center from April 1, 2024, to March 31, 2025, excluding EUS-guided choledochoenterostomy cases. Proceduralists documented key data in ProVation using custom-required fields. Data abstractors reviewed medical records and conducted follow-up calls at 3–7 and 14–30 days post-procedure. Data was integrated into a Power BI dashboard with filters for proceduralist, encounter type, patient- and procedure-related risk factors, and preventive measures for adverse events. Reported outcomes included intraprocedural and delayed adverse events, ER/urgent care visits, hospital admissions, and repeat ERCPs within 14 days. Proceduralists were given view-only access to the dashboard. Results: A total of 2,557 ERCP procedures were analyzed. The native papilla cannulation success rate was 98.9%. Intraprocedural complications included gastrointestinal bleeding (0.94%) and perforation (0.16%). DAE included pancreatitis (2.11%), infection (1.21%), GI bleeding (1.68%), perforation (0.27%), cholecystitis (0.20%), severe pain (4.81%), and related mortality (0.23%). Related post-procedure care included ER/urgent care visits (4.30%), hospital admissions (5.32%), and unplanned repeat ERCPs (3.56%). Conclusion: Our ERCP quality dashboard facilitates robust assessment of post-procedure outcomes. Key strengths include reduced bias from physician self-reporting, ability to filter outcomes by notable patient and procedure specific risk factors, and inclusion of DAE in patients who sought care outside the health center. Limitations include need for abstractor manual data review. Future efforts will focus on developing methods of automating data collection and leveraging the dashboard to identify and monitor specific areas of ERCP quality improvement.