Clinical

BSG Quality Improvement Project

Dr Tony Tham, BSG Quality Improvement Lead and Deputy Chair, BSG Clinical Services and Standards Committee

The mission of the BSG is to support its members to provide the best care and achieve the best outcomes for patients with gastrointestinal and liver diseases. As one of the ways to achieve this, the BSG has embarked on a quality improvement project through the Clinical Services and Standards Committee (CSSC).

The gastroenterology community has a proven track record with the GRS and JAG, and the high standards achieved by a JAG accredited endoscopy unit. The objective of the quality improvement project is to improve standards of care across a wider set of clinical areas outside endoscopy. Patients with gastrointestinal and liver disease will benefit from knowing that quality of care throughout the UK for such patients is actively being reviewed and improved, and that there is equality and little variation of care wherever they go. Health system regulators, funders and commissioners will be able to reference the extent to which a service is reaching agreed markers of quality and driving ongoing improvement. Gastrointestinal and liver units can use these standards as a lever to improve services. Units that adopt and meet required quality improvement standards might, if a strong case was made, be rewarded with best practice tariffs in England. Healthcare providers that achieve these standards should feel a well deserved sense of satisfaction but it is equally hoped that a culture of constant improvement can be instilled throughout services nationally. In the future, if accreditation of whole services were to become a reality, such units will be in a good position to achieve certification status.

The BSG has had discussions with the presidents and representatives from the Association of Upper Gastrointestinal Surgeons, Association of Coloproctology of Great Britain and Ireland, patient groups, representatives from the Clinical Service Accreditation Alliance (CSAA) and Liver QuEST. CSAA is a collection of colleges, professional bodies, regulators, commissioners and patients who have come together tostandardise and improve the quality of healthcare service accreditation, with the Royal College of Physicians of London being the lead body. Liver QuEST will be a project familiar to many in the liver community (see BSG Summer 2016 newsletter), and has seen active participation from BSG members in pilot hospitals as a means to drive quality improvement in liver services.

We realise that the work involved in coming up with standards and measures is significant. We are also very aware of the need to ensure that the time involved for teams to provide evidence is not too burdensome or an interference with good clinical care. The quality improvement project will take time to achieve its ultimate aims and the journey is just beginning. As a starting point, we are working with leads from CSAA and Liver QuEST to develop a template and key questions from which relevant sections from the BSG will be able to build their own standards and measures.

We look forward to working with members of the BSG in this quality improvement project and welcome any feedback that you may have.

RCP Future Hospital Journal

Dr Tony Tham, BSG Quality Improvement Lead and Deputy Chair, BSG Clinical Services and Standards Committee

Embedding quality improvement into routine clinical practice The editor, Ed Nicol, of the Future Hospital Journal, a Journal of the Royal College of Physicians challenges us with this observation. "Our patients rightly expect quality healthcare, our politicians expect the £100bn funding of the NHS to deliver quality healthcare and we, as clinicians, strive to deliver quality healthcare; so why is quality improvement (QI) so difficult to routinely deliver, and why does it remain a Cinderella function in healthcare?”

The recent Future Hospital Journal has presented a series of articles that offer readers the opportunity to view quality improvement from multiple perspectives including theory, educational requirement, delivery and intended outcomes of quality improvement.

I have selected some articles from this journal that look at quality improvement from aspects including quality improvement science: http://futurehospital.rcpjournal.org/content/3/3/199.full.pdf+html