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Prof Steve Patchett,
QI Programme Working Group Chair
30th Nov 2017
National GI Endoscopy Quality Improvement
Programme Annual Participant Workshop
Welcome, Introduction and Programme Update
Welcome – Housekeeping
• Please note the exits
• Please do sign in to receive your CPD credits
– If you attended the ERS Forum from 12:30-1:30 please sign in for this as well to receive your extra CPD credit (+1 credit)
– Please confirm your email address is correct to receive your CPD certificate
Agenda
• Welcome
• Programme Update and Achievements thus far
• Guidelines Update
• Structure Update
• Programme Next Steps
– IT Upgrades
Format of the Workshop
• Start with 2 presentations from 1:45-3:00– End with 10 min Q&A session with whole group
• Three round table discussions from 3:20-4:50: – 5-10 min presentation from speaker
– 5-10 min discussion at your round table prompted by questions provided. Use your flipchart to record your thoughts on each topic. Watch the clock!
– 5-10 min recap. Each table has a facilitator who will present the discussion to the larger group
– Points made during the discussions will be included in a bulletin sent out post-Workshop via email
• Your participation is key!
Achievements and Progress to Date
• Addition of 3 hospitals to the Live column
since last Workshop
• 38 Hospitals now live on NQAIS-Endoscopy
• 31 Public, 7 Private
Guidelines and Target Setting
• Guidelines and Targets – updated
– Screening and Symptomatic Guidelines have been combined
–Addition of “minimum” and “achievable” targets for some KPIs
–Guidelines highlight the importance of higher procedure numbers
–Added section highlighting importance of Caecal Intubation Photographic Evidence
Guidelines and Target Setting Key Quality Area
Previous Guidelines
New Guidelines/BowelScreen Guidelines Link
Volume of Procedures
No recommendation of a minimum volume of procedures.
The QI Programme’s Guidelines note The QI Programme continues to not require or recommend a minimum volume, however notes that those with higher procedure volumes will more likely be able to maintain their other KPIs. BowelScreen’s requirement that their Endoscopists perform a minimum of 300 colonoscopies (screening and symptomatic combined).
CaecalIntubation
Rate
Target: >90% of all cases should reach the caecum
Minimum Target: ≥90% of all cases should reach the caecum
Achievable Target: ≥95% of all cases should reach the caecum
Key Quality Area
Previous Guidelines New Guidelines/BowelScreenGuidelines Link
Caecal Intubation Photographic Evidence
N/A A section regarding this has been added.
Polyp Detection Rate
Target: ≥20% should have 1 or more polyps detected
Same Target.
The Guidelines now note the BowelScreen Programme’s standards regarding adenoma detection rate. The QI Programme continues to measure polyp detection rates.
Reversal Agent Usage
No Target Set
Recommended reviewing usage.
Target: <1% of all cases should have a reversal agent used
Bowel Prep Target: ≥90% of cases should have adequate or excellent bowel prep
Minimum Target: ≥90% of cases should have adequate or excellent bowel prep
Achievable Target: ≥95% of cases should have adequate or excellent bowel prep
Adverse Events
No Targets or Recommendations Set
Colonoscopy Perforation Rate Target:
<1 per 1000 colonoscopies performed
Post Polypectomy Perforation Rate Target:
<2 per 1000 colonoscopies performed
Post Polypectomy Bleeding Rate Target:
<1% of colonoscopies where polypectomy is performed
Post Colonoscopy Colorectal Cancer Rate (PCCRC)
N/A A new section regarding the Post Colonoscopy Colorectal Cancer Rate is now included which notes that both the QI Programme and BowelScreen Programme are a number of years away from being able to calculate this statistic.
Key Quality Area
Previous Guidelines New Guidelines/BowelScreen Guidelines Link
Reporting Structure Update
• All Hospital Group Clinical Leads have now been appointed
• Hospital Group Leads have access to a NQAIS-Endoscopy account that can create Hospital Group Reports
• Hospital Group Leads will be made aware of the ID numbers of each hospital in their Group in the National Data Report
• To identify your hospital ID, please ask your Clinical Lead to contact your Hospital Group Lead.
Programme Next Steps
Initiation
Engagement
Stakeholders
Design:
Guidelines
Data Collection –LIS
Data Recording
NQAIS
Roll-out
Conducting
Recording
Reporting on NQAIS
Measure
Data analysis
Target Setting Methodology
Control
Targets set
Programme Embedded into normal operations of all endoscopy units
11
Framework set up :•Guidelines•Quality Data Collection•Quality Data Reporting•Intelligent Targets set
GI Endoscopy36 sites collecting & recording data on NQAIS
07/12/2017
Moving from Rollout phase to Measure and Control phases • National data analysis
programmes• Target validation and
target setting • Final rollout of
programme to remaining hospitals
NQAIS-Endoscopy Upgrades
• There is now a “help” button in NQAIS-Endoscopy that will enable you to submit IT queries:– Located on the top of the NQAIS screen
NQAIS-Endoscopy Upgrades
NQAIS-Endoscopy Upgrades
• Posters will be sent with out with IT issue resolution details
• NQAIS-Endoscopy will undergo an upgrade over the next year.
• This is intended to make NQAIS more user friendly and intuitive.
• Your feedback in this process will be essential.
– Please fill out evaluation forms and select your preferred graph types
Next Steps
• NQAIS-Endoscopy Upgrade– Making NQAIS more intuitive and user friendly
– Your feedback today will inform its design
• Roll Out: Final Public Hospitals are due to Go-Live on NQAIS by end of Q1 2018
• Embedding: Secondary Site Visits for further training and information on how to get the best out of NQAIS will take place in 2018
Thanks