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