Subscribe to RSS
DOI: 10.1055/s-0040-1704697
A NATIONAL SURVEY OF SAFETY ACROSS UK ENDOSCOPY SERVICES
Publication History
Publication Date:
23 April 2020 (online)
Aims To understand factors related to safety across UK endoscopy in line with the Joint Advisory Group on GI Endoscopy (JAG) ‘Improving Safety and Reducing Error in Endoscopy’ (ISREE) strategy.
Methods An expert panel devised questions across 7 themes, complementing JAG safety domains. These were incorporated into the biennial census of UK JAG-registered services in April 2019.
Results The response rate was 68.4%. Across March 2019, a total of 1535 patient safety incidents were reported (mean 4.80, SD 11.869). There was a significant difference in reporting dependent on incident type (χ2(7) = 308.1, p < 0.001). Technical and training incidents were least likely to be reported. There was no effect of region, service type or JAG accreditation status on reporting.
Anaesthetic-supported (AS) lists were unavailable to 27% of services. This varied amongst service type (χ2(4) = 67.86, p < .0005) but not region (p = 0.13). There was a significant difference between the current and desired number of AS lists (p < 0.001).
The majority of acute services have a gastrointestinal bleed (GIB) service (82.2%) but provision is significantly different between regions (p < 0.001). Accreditation (χ2(1) = 12.04, p < 0.01) and AS lists (χ2(1) = 18.90, p < 0.01) were strongly associated with having a GIB service.
Overall, 66.1% of services reported having an effective strategy for supporting underperformance. More endoscopists require support for technical skills than non-technical skills
(Z = −5.35, p = 0.001). Simulation provision was 49.1% across acute services, with significant regional differences (p = 0.001).
Learning is shared following discussion of adverse events in 94.1% services. Patient feedback is used to support learning, training and quality improvement.
Conclusions This is the first survey of national endoscopy safety practice and highlights regional and service-specific variability. These results are important in guiding the ISREE strategy in supporting safer UK endoscopy.
#