Gastrointestinal Endoscopy National Quality Improvement Programme

Colonoscopy.
Doctor reading patient notes.

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. 

"Endoscopy is a central element in the diagnosis of gastrointestinal (GI) disease. The provision of a high quality, timely and accurate service with an associated quality patient experience is a key goal for all. Patients have a right to expect that they have appropriate access to the service and that the service provided is of the highest possible standard."

Conjoint Board of RCPI and RCSI

What is Gastrointestinal Endoscopy?

Gastrointestinal Endoscopy is a diagnostic procedure that involves an examination of the inner lining of the gastrointestinal tract.

An upper gastrointestinal endoscopy examines the oesophagus, stomach, and the first part of the small intestine (duodenum). The viewing tool, called an endoscope, is passed through the mouth.

A colonoscopy examines the inner lining of the large intestine (rectum and colon). This is performed by passing a small flexible tube through the rectum.

 

Doctor with patient

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.

Download the 2016 National Data Report

This is the first annual report produced by the the GI Endoscopy QI Programme reporting on quality indicators in endoscopy

"GI endoscopy is fundamental to the management of upper and lower gastrointestinal disease. It has diagnostic, therapeutic and preventative roles. All endoscopy procedures need to strike a balance between benefit and harm."

Conjoint Board of RCPI and RCSI

Doctors reviewing notes.

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.

Guidelines for Endoscopy Units

The guidelines were developed by a Working Group of endoscopist physicians, surgeons and a nurse, who were appointed by the Conjoint Board of RCPI and RCSI.

They outline quality improvement activities that should be carried out in endoscopy units based on international best evidence.

The guidelines have been circulated to all participating public and private endoscopy units.

Download Guidelines

Guidelines for the Gastrointestinal Endoscopy National Quality Improvement Programme, version 5

Doctor working on computer.

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.

participating hospitals
Bantry General Hospital Beacon Hospital Beaumont Hospital
Blackrock Clinic Bon Secours Hospital Dublin Bon Secours Hospital Galway
Bon Secours Hospital Tralee Cavan General Hospital Connolly Hospital Blanchardstown
Cork University Hospital Galway Clinic Letterkenny General Hospital
Louth County Hospital Mallow General Hospital Mater Misericordiae University Hospital
Mater Private Hospital - Dublin Mercy University Hospital Midland Regional Hospital at Tullamore
Mid-Western Regional Hospital Ennis Mid-Western Regional Hospital, Nenagh Monaghan General Hospital
Our Lady of Lourdes Hospital, Drogheda Roscommon County Hospital Sligo University Hospital
South Infirmary Victoria University Hospital South Tipperary General Hospital St. James's Hospital
St. John's Hospital, Limerick St. Luke's General Hospital St. Michael's Hospital
St. Vincent's University Hospital Tallaght Hospital University Hospital Galway
University Hospital Kerry University Hospital Limerick University Hospital Waterford
Wexford General Hospital
 

Working with the health service

The Gastrointestinal Endoscopy National Quality Improvement Programme is led by the Conjoint Board of RCPI and RCSI.

It has received wide support and is governed by a Steering Committee with representation from:

  • HSE Quality Improvement Division
  • Private Hospitals Association 
  • HSE Office of the Chief Information Officer
  • HSE Acute Hospitals Directorate
  • Department of Health
  • Roycal College of Surgeons in Ireland 
  • Clinical Endoscopist
  • National Lead for Endoscopy 
  • National Office of Clinical Audit 
  • Health Information and Quality Authority (HIQA) – observer
Group of doctors having discussion.

GI Endoscopy QI Programme Workshop Review 

Thanks to all who attended the 2016 Endoscopy QI Programme Workshop. Your participation on the day was very much appreciated. Links to the presentations given on the day are below. Please share these presentations with your colleagues.

We welcome any feedback or queries to Conor Canavan or Sarah Treleaven (conorcanavan@rcpi.ie or sarahtreleaven@rcpi.ie).  

Contact Us

If you have any questions about the Specialty Quality Improvement Programmes, please contact:

Sarah Treleaven

Project Executive, Specialty Quality Improvement Programmes

Tel: +353 1 863 9619

Sarah provides project support to National Quality Improvement Programmes in

  • Histopathology
  • Radiology
  • Gastrointestinal Endoscopy

Philip Ryan

Technical Administrator, Specialty Quality Improvement Programmes

Tel: 01 863 9745

Philip provides project support to National Quality Improvement Programmes in

  • Histopathology
  • Radiology
  • Gastrointestinal Endoscopy

Conor Canavan

Project Executive, Speciality Quality Improvement Programmes

Tel: + 353 1 863 9732

Philip provides project support to National Quality Improvement Programmes in

  • Histopathology
  • Radiology
  • Gastrointestinal Endoscopy