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Paediatric Endoscopy Global Rating Scale: Development of a Quality Improvement Tool and Results of a National Pilot
Priya Narula1, Raphael Broughton2, Lucy Howarth3
1Department of Paediatric Gastroenterology, Sheffield Children's NHS Foundation Trust. Sheffield.
Insights
A new Paediatric endoscopy Global Rating Scale (P-GRS) was developed and piloted. This quality improvement tool helps paediatric endoscopy services identify areas for enhancement and improve patient care.
Area of Science:
- Paediatric Gastroenterology
- Quality Improvement Tools
- Healthcare Management
Background:
- The adult endoscopy Global Rating Scale (GRS) has improved quality in UK adult endoscopy services.
- The adult GRS is not suitable for paediatric endoscopy services, necessitating a specialized tool.
- Quality improvement (QI) is crucial for enhancing patient safety and outcomes in medical procedures.
Purpose of the Study:
- To develop and pilot a Paediatric endoscopy Global Rating Scale (P-GRS).
- To adapt the GRS framework for paediatric endoscopy services as a QI tool.
- To assess the relevance and utility of the P-GRS in a national paediatric setting.
Main Methods:
- Collaboration between the British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) Endoscopy Working Group and the Joint Advisory Group on Gastrointestinal Endoscopy (JAG).
- Development of the P-GRS, mirroring the adult GRS structure with 4 domains and 19 standards.
- National pilot study conducted at 9 centres with prospective data collection at two time points in 2016.
Main Results:
- The P-GRS was found to be relevant to paediatric endoscopy services.
- Pilot sites identified areas for improvement and reported positive developments.
- Data collection involved 8 services in May 2016 and 6 in December 2016.
Conclusions:
- The national pilot confirmed the P-GRS's relevance and utility for paediatric endoscopy services.
- Early engagement with the P-GRS facilitated identification of improvement areas and sharing of best practices.
- The P-GRS supports the development of QI plans and enhances patient involvement in paediatric endoscopy services.
Introduction And Objectives:
The endoscopy Global Rating Scale (GRS) is a web-based self-assessment quality improvement (QI) tool that provides a framework for service improvement. Widespread use of the GRS in adult endoscopy services in the United Kingdom (UK) has led to a demonstrable improvement in quality. The adult GRS is not directly applicable to paediatric endoscopy services. The objective of this study is to develop and pilot a paediatric endoscopy Global Rating Scale (P-GRS) as a QI tool.
Methods:
Members of the British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) Endoscopy Working Group collaborated with the Joint Advisory Group on Gastrointestinal Endoscopy (JAG) to develop the P-GRS. After a period of consultation, this was piloted nationally at 9 centres and data were collected prospectively at 2 census points, May and December 2016.
Results:
The P-GRS mirrors the adult GRS by dividing care into 4 domains and includes 19 standards with several measures that underpin the standards. Eight services completed the online P-GRS return in May 2016 and 6 in December 2016. All pilot sites identified areas that needed improvement and post-pilot reflected on the key challenges and developments. Several positive developments were reported by the pilot sites.
Conclusions:
The national pilot helped ensure that the P-GRS developed was relevant to the paediatric endoscopy services. The pilot demonstrated that even in the first year of engaging with this QI tool, services were starting to identify areas that needed improvement, share best practice documents, put in place QI plans, and support greater patient involvement in services.
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