British society of gastroenterology Endoscopy Quality Improvement Programme (EQIP): overview and progress

Abstract

High quality gastrointestinal (GI) endoscopy improves patient care. Raising standards in endoscopy improves diagnostic accuracy, management of pathology and ultimately improves outcomes. Historical identification of significant variation in colonoscopy quality led to the development of the Joint Advisory Group (JAG) on GI Endoscopy, the Global Rating Scale (GRS), JAG Endoscopy Training System (JETS) training and certification. These measures led to major improvements in UK endoscopy but significant variation in practice still exists. To improve quality further the British Society of Gastroenterology Endoscopy Quality Improvement (EQIP) has been established with the aim of raising quality and reducing variation in the quality of UK endoscopy. A multifaceted approach to quality improvement (QI) will be undertaken and is described in this manuscript. Upper GI EQIP will support adoption of standards alongside regional upskilling courses. Lower GI EQIP will focus on supporting endoscopists to achieve current standards alongside approaches to reducing postcolonoscopy colorectal cancer rates. Endoscopic retrograde cholangiopancreatography EQIP will adopt a regional approach of using local data to support network-based QI. Newer areas of endoscopy practice such as small bowel endoscopy and endoscopic ultrasound will focus on identifying key performance indicators as well as standardising training and accreditation pathways. EQIP will also support QI in management of GI bleeding as well as standardising the approach to new techniques and technologies. Where evidence is lacking, approaches to gather new evidence and support the translation into clinical practice will be supported.

British Society of Gastroenterology (BSG)-led multisociety consensus care bundle for the early clinical management of acute upper gastrointestinal bleeding

“…The UK AUGIB care bundle was developed as part of the BSG Endoscopy Quality Improvement Programme (EQIP). 15 The steering committee comprised a multidisciplinary group of experts from BSG, Association of Upper Gastrointestinal Surgeons, National Health Service (NHS) Blood and Transplant, Society for Acute Medicine, with trainee and patient representation. The consensus process involved a modified Delphi method.…”

Impact of cumulative experience on the quality of screening colonoscopy: A 13-year observational study

“…Organisations such as the British Society of Gastroenterology have established programmes to monitor standards, such as the Endoscopy Quality Improvement Programme in order to reduce heterogeneity in training and standards in the UK. 9 Our study findings may emphasise the importance of case volume of endoscopic practice, which represents a challenge that must be addressed for the training of future screening endoscopists.…”

Heterogeneity in colorectal cancer incidence among people recommended 3-yearly surveillance post-polypectomy: a validation study

“…A further limitation is that our data on baseline colonoscopies were from the mid-1990 s to early 2000 s, whereas data on surveillance colonoscopies were obtained through 2006 for KPCP and 2012 for UKFSST and ECP. As colonoscopy quality has significantly improved over the past two decades 27 , our results may be overestimating CRC risk after baseline colonoscopy and/or underestimating the benefit of surveillance. It is possible that we missed some surveillance examinations, despite endeavoring to obtain complete data.…”