Peer Review of Paediatric Endocrine Services in the UK: A Template for Quality and Service Improvement
John Schulga1, Heather Mitchell2, S Faisal Ahmed3
1NHS Forth Valley Women & Children Department, Forth Valley Royal Hospital, Larbert, UK.
Insights
A national peer review of UK paediatric endocrine services was feasible and acceptable. This quality benchmark can be replicated by other national healthcare services.
Area of Science:
- Healthcare Quality Improvement
- Paediatric Endocrinology
- Clinical Governance
Background:
- Independent peer review complements existing healthcare quality improvement mechanisms.
- No prior national peer review had been reported for UK paediatric endocrinology services.
- This study piloted a national peer review for paediatric endocrine services in the UK.
Purpose of the Study:
- To assess the feasibility and acceptability of a national peer review process for paediatric endocrine services in the UK.
- To establish a quality benchmark for these specialized services.
Main Methods:
- All 22 UK tertiary paediatric endocrinology centres were evaluated against 54 quality standards developed by the British Society for Paediatric Endocrinology and Diabetes (BSPED).
- A multidisciplinary team comprising paediatric endocrinologists and specialist nurses conducted the peer review, supported by self-assessments.
- Feedback was collected via post-peer-review questionnaires.
Main Results:
- All 22 centres participated between 2011 and 2017.
- A median of 43 out of 54 standards were met across centres.
- Centre adherence to essential standards varied (52-97%), with 32% meeting 90% of standards.
- 95% of centres validated the utility of the peer review process.
Conclusions:
- The British Society for Paediatric Endocrinology and Diabetes (BSPED) national peer review is feasible for UK paediatric endocrine services.
- The process establishes a valuable quality benchmark for potential replication by national healthcare services.
Background:
Independent peer review of healthcare services can complement existing internal-, institutional-, and national-level regulatory mechanisms aimed at improving quality of healthcare. However, this has not been reported for paediatric endocrinology services in the UK. We aimed to test feasibility and acceptability through a first cycle of a national peer review of paediatric endocrine services.
Methods:
Tertiary centres in paediatric endocrinology across the UK were assessed against 54 quality standards, developed by the British Society for Paediatric Endocrinology and Diabetes (BSPED) in five domains of healthcare by a team comprising paediatric endocrinologists and specialist nurses. The evaluation was supported by a self-assessment. A post-peer-review questionnaire was used as feedback.
Results:
All 22 centres in the UK underwent independent peer review between 2011 and 2017. Each served a median population of 2.6 million (range 1-8 million) and offered 1,872 (range 779-6,738) outpatient consultations annually. A total of 43 (range 30-49) standards were met in combined evaluation of all centres. Variance of adherence for essential standards ranged from 52 to 97% at individual centres with 90% adherence demonstrated by 32% of centres. Post-review feedback showed 20/22 (95%) validating the utility of the peer review.
Conclusions:
The BSPED peer review of all UK centres providing paediatric endocrine services is shown to be feasible and provides a quality benchmark for replication by national services.
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