The Global Rating Scale in Endoscopy

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The Global Rating Scalein Endoscopy

• National Endoscopy Team
• September 2005

www.endoscopy.nhs.uk
www.grs.nhs.uk
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The April Census
Results 189 sites registered and completed the
census. 12 / 28 SHAs achieved 100 completion.

• Factors influencing completion rates of GRS
• Early engagement with endoscopy units
  (preparation)
• Clear communication
• Support from Endoscopy Leads
• Early agreement about how the GRS will be used
• A recent endoscopy event

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The April Census..Contin
Feedback What did you tell us?

• Small teething problems
• Clarification of language and measures
• Development of a robust knowledge management
  support (KMS) section within GRS.
• Action Planning
• Other recommendations and suggestions
• Endoscopy Global Rating Scale progress report for
  England-June 2005

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Quality and Safety-Results
www.grs.nhs.uk
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Customer Care-Results
www.grs.nhs.uk
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Endoscopy The key Priority Areas

• To define workforce and training needs on the
  basis of service demand
• To spread training centre expertise to peripheral
  units
• To support the implementation/integration of the
  ISP
• To support the implementation of the bowel cancer
  screening programme
• To apply screening programme quality standards
  across the service

• To keep delivery of the endoscopy programme
  (particularly of knowledge and support) one step
  ahead of Service expectations
• To implement a traffic light system to monitor
  progress on waits and detect and support
  providers that will fail to achieve milestones
• To Implement a robust Knowledge Management System
  to support GRS

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Distribution of GRS scores - May 2005
www.grs.nhs.uk
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Item aftercare, levels C and B
C
There are procedure specific aftercare patient
information sheets for all procedures performed
in the department
X
Yes
No
No
X
Yes
There is a 24 hour contact number for patients
who have questions and experience problems
X
No
Yes
All patients are told if they are suspected of
having a malignancy on the same day as the
procedure
X
No
Yes
If it is considered inappropriate to tell the
patient malignancy is suspected, a note is made
in the file of the reason
B
All patients are discharged with verbal and
written information about next steps appropriate
for their care
X
Yes
No
X
No
Yes
All patients are told the outcome of the
endoscopic procedure prior to discharge
All patients are told if further information from
pathological specimens will be available, from
whom and when
X
No
Yes
X
No
Yes
Patients views on aftercare processes are sought
at least annually
www.grs.nhs.uk
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New Action Planning Functionality

• - Identifies Priorities for action
• - 18 Weeks
• - Cancer Screening
• Unit Accreditation

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• The System will automatically populate your
  areas for action
• Two options available

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Action Planning
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Timeliness of endoscopy 198 units
April 2005
D C B
A
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Traffic light system expectation of achieving a
given level
10/05
04/06
10/06
NOW
Level D X
Level C X
Level B
X
Level A
X
Service doing well no action required
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Traffic light system expectation of achieving a
given level
10/05
04/06
10/06
NOW
Level D X X
X
Level C
X
Level B

Level A

Service not doing well support required
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GRS Knowledge Management

• How will it support the service?
• The knowledge management system will support
  users to improve the quality of their service by
  enabling them to progress to higher levels in the
  Global Rating Scale
• The Knowledge management
  steering group July 2005

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GRS Knowledge Management

• The KM system for endoscopy will
• Share and provide all existing knowledge across
  the service
• Generate new knowledge to support the services
• Accessing valuable knowledge from outside
  services
• Embed knowledge of what works
• Measure the impact on the service through GRS
• Benefits?
• Improves immediate information and support at the
  frontline
• Its accessible
• Should help teams to resolve issues more speedily

WARNING - Should not be seen as a quick fix
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GRS Knowledge Management

• How is the information being gathered?
• National Steering Group for KM-representatives
  from all levels of the service
• Focus on quality information
• 12 KM/GRS Item Leads-Key responsibilities
• Knowledge management Co-coordinator-support
• Phase 1-core information Level A sites
• Phase 2-case studies

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Access to Knowledge Management
Access directly through the Home page or From
each Item or Through the action plans No Login
required
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Ambiguities Hover-over information
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Select underlined measure to view Knowledge Base
information for that measure
Examples and guidance a click away
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Maximised view of Knowledge Base

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

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Ask a question?
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Your Feedback of Information
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Search the Knowledge Base
Specific searches e.g. - Consent - Withdrawal of
consent - Nurse led consent package
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What can you do?

• Test the system
• Feedback to us
• Input your own knowledge into the system
• Use it!
• Share across the patch
• KEY CONTACTS
• debbie.johnston_at_endoscopy.nhs.uk
• Lead for Knowledge Management
• vidhya.kara_at_endoscopy.nhs.uk
• Knowledge Management Co-ordinator
• Please contact for any specific requests /
  requirements

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