Endoscopy Global Rating Scale

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Endoscopy Global Rating Scale Knowledge
Management System

• National Endoscopy Team
• May 2007

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• What is the GRS?

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Endoscopy Global Rating Scale
The GRS evolved from a desire to determine
whether endoscopy units were providing a
patient-centred service
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Endoscopy Global Rating Scale

• From this need a fundamental question arose

What matters to a patient having an endoscopy?
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What matters to a patient having an endoscopy?

• At a series of meetings held throughout England
  endoscopy staff were asked what they thought was
  important for a patient having an endoscopy
• from their responses the 12 items of the
  Endoscopy Global Rating Scale were created

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Twelve patient-centred standards

• Quality of patient experience
• equality
• timeliness
• choice
• privacy and dignity
• aftercare
• ability to provide feedback

• Clinical quality
• appropriateness
• information/consent
• safety
• comfort
• quality
• timely results

endoscopy global rating scale
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Endoscopy Global Rating Scale

• In the first stage of development levels of
  achievement (D-A) were created, where level D was
  basic and level A an excellent service
• Descriptors were formulated for each level

Descriptor a statement that describes what has
been achieved at a given level of the scale
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GRS - levels and descriptors for the Quality item

• Level D
• Nationally agreed quality standards are published
  in the department
• Level C
• There are processes in place to monitor the
  standards
• Level B
• Action is agreed if performance falls below the
  standards
• Level A
• Action taken in response to poor performance is
  reviewed to ensure the action is effective

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Endoscopy Global Rating Scale

• To lend objectivity each descriptor was
  underpinned by two to five measures

Measure a statement that describes a process or
standard
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Endoscopy Global Rating Scale
The patient experience
P
2 dimensions clinical quality quality of
the patient experience
1 2
12 patient centred items
1 2 3 4 5 6
Each item has four levels A-D (descriptors)
D C B A
Each level is underpinned with 1-4
measures
1 2 3
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Endoscopy Global Rating Scale

• To facilitate reporting of scores a web-based
  reporting system was created

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Global Rating Scale Homepage
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Each Item has a series of statements that have to
be answered yes or no
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• What has the GRS achieved?

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Endoscopy Global Rating Scale

• National census twice yearly
• (April and October)
• A pilot study was undertaken in September 2004
• Five further censuses have been held at six month
  intervals
• The GRS is now used as the quality standard for
  JAG and bowel screening accreditation visits

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GRS National resultsone item -
five censuses over two years (207 units)
scoring A or B
this slide is the key for the next two
level B or better (A for timeliness) is our
current standard for an acceptable service
04/07
10/06
04/06
10/05
04/05
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we are expecting 97 completion for this census
GRS National results
Completion rates
scoring A or B
85
94
100
97
92
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GRS National results
Completion rates
scoring A or B
85
94
100
97
92
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What is the purpose of the GRS?

• The Primary aim of the GRS is to
• support quality and service improvement by
  helping endoscopy staff identify areas in need of
  attention
•  
• The secondary aims of the GRS are to
• be used as a quality standard in the JAG and
  Bowel Cancer Screening accreditation process
• support the delivery of national targets
• Possible future uses of the GRS
• as a commissioning tool
• to inform patient choice

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GRS Service Improvement

• The GRS provides a framework on which to
  prioritise tasks
• The web-based knowledge management system links
  solutions directly to problems

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GRS Knowledge Management

• The Knowledge Management System
• Shares existing knowledge across the service
• Generates new knowledge to support the service
• Provides knowledge from outside the service
• Embeds knowledge of what works
• Benefits
• Immediate information and support at the
  frontline
• A sharing community
• Helps teams resolve issues more rapidly

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• Knowledge Base
• No Login required
• KMS Demo
• Constantly updated
• Quick and easy

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Access to the KMS
Access directly through the GRS Home
page or From each measure or Through the action
plans No Login required
www.grs.nhs.uk
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View of Knowledge Base
adopt and adapt

• Getting Started
• Policy and guidelines
• Audit Tools
• Useful Links
• Patient Information
• Sample Questionnaires
• Presentations
• Case Studies
• General Folder New!

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What's New?
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New Domains and Tools

• Workforce Domain
• Training Domain
• Productivity Tool

See separate presentation for more information on
these new domains
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The GRS has achieved a great deal

• Raised the profile of endoscopy
• Improved teamwork
• Improved standards
• Identified service gaps
• Provided evidence for investment
• Supported quality assurance

It has improved the patients experience of
endoscopy
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