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Cystoscopy:75 years on. ? . Flexibility of Project Cystoscopy nurse left post Alternative software product Enhanced utility Quarter of cost. Flexible cystoscopy:the challenge. Highest incident procedure in urology Diagnostic and surveillance utility. CCI:the process.
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Flexibility of Project Cystoscopy nurse left post Alternative software product Enhanced utility Quarter of cost
Flexible cystoscopy:the challenge Highest incident procedure in urology Diagnostic and surveillance utility
CCI:the process • Analysis-understanding the patient journey • Understanding the system-demand ,capacity ,activity and backlog • Measurement • Queueing theory
CCI Project :the result 9 week wait Teamwork • Improved referral pathways • One stop clinics • Pooling of waiting lists • Increased flexibility of working • Increase in capacity
Better Health Better Care Action Plan: 6 Dimensions of Quality • Timeliness • Patient centred • Safe • Effectiveness • Equitable • Efficient
Flexible cystoscopy and the Global Rating Scale(GRS) • How many flexible cystoscopies per annum/ per consultant in Scotland? • Which guidelines do you use? BAUS EAU AUA • What evidence can you produce for revalidation/recertification about quality/outcome of your flexible cystoscopies?
Endoscopy Global Rating ScaleNational census twice yearly (April and October) • Following a pilot in September 2004 six national censuses have been held at six month intervals • The GRS is now used as the quality standard for JAG and bowel screening accreditation visits www.grs.nhs.uk
What has the GRS achieved? www.grs.nhs.uk
GRS – National resultsone item -six censuses over 2.5 years (207 units) level B or better is the current standard for an acceptable service % scoring A or B 04/07 10/07 10/06 04/06 04/07 10/06 10/05 10/05 04/05
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 1-5 measures 1 2 3 www.grs.nhs.uk
Allow us to address the quality dimensions • Provide an audit tool • Improve the quality and safety of flexible cystoscopy Summary