Giving patients greater confidence in endoscopy test results

The Gastrointestinal Endoscopy National Quality Improvement Programme aims to give patients greater confidence in the diagnosis of illnesses regardless of whether they are tested at a large or small hospital, either public or private.

It endeavours to strengthen patient safety efforts in local hospitals and enhance patient care with accurate and complete endoscopy diagnoses and reports.

Launched in 2011, it has the following objectives:

• Improve patient care by minimising diagnostic errors in Gastrointestinal Endoscopy
• Develop a standardised national quality improvement system for Gastrointestinal Endoscopy
• Enable individual endoscopy units to review their performance against national targets
• Identify good practice and areas for improvement and share findings with other participating units
• Improve communication within and between participating institutions

A clinician led Quality Improvement Programme in GI Endoscopy was developed under the remit of the Conjoint Board in Ireland of the Royal College of Physicians and Royal College of Surgeons in conjunction with the Quality Improvement Directorate of the HSE. The programmed is managed by RCPI. 

Why was this programme established?

The Gastrointestinal Endoscopy National Quality Improvement Programme was developed by the Conjoint Board of RCPI and RCSI in 2011.

Gastrointestinal Endoscopy, like many diagnostic procedures, involves decision making under conditions of uncertainty and a certain degree of error is inevitable.

Endoscopy and colonoscopy can be performed by specially trained nurse endoscopists, surgeons or physicians, which is why RCPI and RCSI are jointly leading this programme.

The Conjoint Board’s aim was to systematically produce robust evidence to ensure that endoscopic procedures in Ireland meet the highest international standards. It also wanted to address the lack of national standards or benchmarks for auditing Gastrointestinal Endoscopy services.

This programme was previously known as the National Quality Assurance Programme in Gastrointestinal Endoscopy.

How the Programme works

Participating endoscopy units have agreed to implement practical quality improvement measures, as outlined in the Guidelines for the Gastrointestinal Endoscopy National Quality Improvement Programme.

The units who have gone live are recording their performance on an online quality information system, which is currently being rolled out to endoscopy units across Ireland.

The Conjoint Board has defined Key Quality Data that will be used to assess the performance of an endoscopy unit. Key quality areas include average medication dosages,  sedative reversal medications usage and polyp detection rates. This information will be recorded in the online quality information system.

When the Gastrointestinal Endoscopy National Quality Improvement Programme is fully implemented, endoscopy units will be able to run their own quality improvement reports. Using our online quality information system, they will be able to review their performance regularly and compare it to the aggregate national performance.

Is your hospital using the National Quality Assurance Intelligence System?

An essential component of the Gastrointestinal Endoscopy National Quality Improvement Programme is an online quality information system that was built to store, analyse and report on endoscopy units’ performance. It was developed by the Conjoint Board of RCPI and RCSI and HSE Health Intelligence Ireland.

Known as NQAIS (National Quality Assurance Intelligence System), it functions as a central repository for quality improvement data.

NQAIS is currently being rolled out to all participating endoscopy units and allows us to generate national reports on the key quality areas in diagnostic endoscopy in Ireland.  

We will produce an overall national report showing the trends in the key quality areas. Endoscopy units will be able to monitor, review and improve the quality of their work in the context of national norms as well as share best practice with other participants.