Background The National Endoscopy Database (NED) project commenced in 2013 under the auspices of the Joint Advisory Group. The aim is to upload endoscopy procedure data from all units across the United Kingdom to a centralised database. The database can be used to facilitate quality assurance, research and training in endoscopy. Objective This article describes the development and implementation process of NED from its inception to date. Methods NED utilises automated data uploading of a minimum dataset from local endoscopy reporting systems to a central national database via the internet. Currently all data are anonymised. Key performance indicators are presented to endoscopists and organisations on a web-based platform for quality assurance purposes. Results As of October 2018, 295 endoscopy services out of a total of 529 known services in the UK (56%) are actively uploading to NED. Data from more than 400,000 endoscopic procedures have been uploaded. Conclusion UK-wide data collection from endoscopy units to a central database is feasible using an automated upload system. This has the potential to facilitate endoscopy quality assurance and research.
Background: The aim of the English Bowel Cancer Screening Programme (BCSP) is to diagnose early colorectal cancer and advanced adenomas. However, other findings are also reported at screening colonoscopy. Small studies demonstrate findings other than cancer or adenomas (non-neoplastic findings (NNF)) in 11-25%. Objectives and setting: Describe the frequency and nature of NNF within the BSCP. Methods: Data were obtained from the BCSP national database for all individuals undergoing colonoscopic investigation after positive faecal occult blood testing between August 2006 and November 2011. Data included demographics, smoking status, neoplastic findings and NNF. Results: 121728 colonoscopies were analysed. 51 NNF were found in 26251 cases (21.6%). Diverticular disease (18875 cases) and haemorrhoids (7011) were the most frequently reported. Inflammatory bowel disease (IBD) was reported in 2152 cases. Individuals with a neoplastic diagnosis were less likely to have an NNF than those without (19.8% v 24.4%, p < 0.001). After adjustment for confounding using multivariable analysis, older age was still associated with a small but statistically significant risk of NNF. Conclusions: The BCSP generates a significant volume of NNF. A small proportion of individuals were found to have inflammatory bowel disease (IBD) -an important diagnosis with implications for long-term management. BCSP participants should be aware that findings other than neoplasia may be detected and the relevance of these findings to that individual is not known. Reporting of NNF varies between colonoscopists, and potential underreporting is a limitation of this study. Further study is required to establish the impact of NNF on primary and secondary care.
Table 3 SIGN OUT -'Sign Off/Strike Off CHALLENGES ENABLERS Time constraints Right patient, right report and right diagnosis Entire team not always present for sign out Two nurses checking reports and specimens before next patient arrives in the room Abstract PTH-142 Table 4 DEBRIEF CHALLENGES ENABLERS Debrief does not happen Boosts morale Endoscopists leaving department without checking patients Identifies any issuesConclusions Endoscopy staff report that human factors present barriers to the performance of checklisting.There is a need to further explore the relationship between direct observation of practice and non-technical skills and whether training in human factors for endoscopy teams can reduce adverse events and improve safety behaviour.
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