Q uality P rogram - E ndoscopy (formerly the Endoscopy Quality Initiative)

AIMS

1. To develop a mechanism for continuous quality improvement in the delivery of endoscopy services in Canada .
2. To demonstrate that gastroenterologists provide quality care and quality endoscopy with available resources.
3. Based on the above, to advocate for additional resources and increased numbers of gastroenterologists.
4. To allow gastroenterologists to obtain a 'quality endorsement' for their endoscopy practice or for their endoscopy unit.
5. To support communication/liaison between gastroenterologists and endoscopy nursing staff and endoscopy unit managers, to improve the overall quality of endoscopy service delivery.
6. To demonstrate that a global assessment of endoscopy services can lead to improvements in specific outcome measures such as patient satisfaction, wait-times and resource utilization.

 The two main elements of the QP-E are:

1. The Global Rating Scale (GRS)¹

The U.K. has led the quality in endoscopy movement since 2004 when Dr. Roland Valori and team introduced the Global Rating Scale¹ – a web-based endoscopy service evaluation tool that evaluates multiple components of endoscopy service from a patient-focused perspective. The GRS examines 12 items related to Clinical Quality and the Quality of the Patient Experience as outlined below:

CLINICAL QUALITY	QUALITY OF THE PATIENT EXPERIENCE
• Consent process including patient information	• Equality of access and equity of provision
• Safety	• Timeliness
• Comfort	• Booking responsiveness and flexibility
• Quality of the procedure	• Privacy and dignity
• Appropriateness	• Aftercare
• Communicating results to referrer	• Ability to provide feedback to the service

The GRS has been adapted for Canada and a Canadian website launched thanks to our U.K.colleagues. If you would like more information on the Canadian GRS please visit http://ca.globalratingscale.com/ and click the ‘View Data Entry’ or ‘Print GRS Forms’ tabs (note that a username and password are not required to access these pages).

¹ NHS Global Rating Scale. Available from: http://www.grs.nhs.uk/default.aspx

2. Smartphone-based Practice Audit on Colonoscopy

This short practice audit examines consecutive outpatients undergoing colonoscopy over a two-week period. Survey questions are completed in the endoscopy suite at the time of the procedure on smartphones lent to participants. The audit provides information on specific colonoscopy outcome measures that serve as baseline data, allowing participants to subsequently determine the effects of their targeted improvements in the GRS.

Key variables recorded include dates of referral, consultation and procedure, insertion and withdrawal times, extent of exam and quality of the bowel preparation. The reporting website for the practice audit is available at: http://cag.medicalconsensus.org/ and aggregate national results may be viewed through the demo site using the username: cagdemo and password: cag (please note that ‘My Data’ on the demo site are fictitious).

If your endoscopy team is interested in participating in the QP-E please e-mail

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