Celtic endoscopy

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Celtic endoscopy

• Goal for the day

Get one up on the English
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Making things happen

• How we adopt change
• Why we adopt change at different rates
• How to accelerate adoption
• How to sustain adoption

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Timeline of change
first awareness
established practice
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Timeline of change
first awareness
established practice
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Timeline of change
first awareness
established practice
awareness
Effective Health Care 19995(1)
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Timeline of change
first awareness
established practice
contemplation
awareness
Effective Health Care 19995(1)
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Timeline of change
first awareness
established practice
contemplation
preparation
awareness
Effective Health Care 19995(1)
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Timeline of change
first awareness
established practice
contemplation
preparation
awareness
action
Effective Health Care 19995(1)
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Timeline of change
first awareness
established practice
contemplation
preparation
maintenance
awareness
action
your position
Effective Health Care 19995(1)
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Uptake of Change
100 50 0
Laggards
Uptake of a change in practice
Late majority
Early majority
Innovators
Early adopters
Time ?
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Accelerating Change
100 50 0
Uptake of a change in practice
Years ?
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Uptake of Change
100 50 0
Laggards
Uptake of a change in practice
Late majority
Early majority
Innovators
Early adopters
Time ?
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Timeline of change
first awareness
established practice
contemplation
preparation
maintenance
awareness
action
Where is your service?
Effective Health Care 19995(1)
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National Endoscopy team
tipping point
training
service delivery
quality assurance
push
push
pull
put the patient first
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We are effective because we have

• clear vision and goals
• effective clinical leadership
• effective clinical engagement
• effective communication
• alignment of agendas (QA, BCSP, training etc)
• a responsive, small team that listens

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We are effective because we have

• tools and guidance that are relevant and
  available
• credible expertise and advice
• the reputation of an effective team that delivers
• kept ahead of the game

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experience
Keeping ahead of expectations
satisfied

dissatisfied
expectation
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Being effective key words

• Vision
• Goals
• Leadership
• Engagement
• COMMUNICATION
• Alignment

• Responsive
• Methods
• Expertise
• Credibility
• Reputation
• Pace

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Quality
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Quality Assurance
Agreement, achievement and demonstration of
standards
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Client Satisfaction
Why is it important?
Growth of theProgramme
JobSatisfaction
Clinical Excellence
Good reputation
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Benefits and risks of high and low quality
screening
Adverse effects of low quality screening
effect
Adverse effects of high quality screening
intensity
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Benefits and risks of high and low quality
screening
Benefits of high quality screening
effect
Benefits of low quality screening
intensity
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Benefits and risks of high and low quality
screening
Harm exceeds benefit
Benefits of high quality screening
Adverse effects of low quality screening
effect
Benefits of low quality screening
Adverse effects of high quality screening
intensity
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Quality assurance - who and what?
individuals
organisations
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Quality assurance
What and how?
standards
processes
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Quality control of individuals
trainee
Certification of competency
all endoscopists
Continuous monitoring of key quality and safety
indicators
competence
performance
established colonoscopist
Revalidation
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Quality assurance - organisations
standards
GRS
processes
Web-based reporting tool
www.grs.nhs.uk
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Patient-centred standards

• Customer care
• equality
• timeliness
• choose and book
• privacy and dignity
• aftercare
• ability to provide feedback to the service

• Quality and safety
• appropriateness
• information/consent
• safety
• comfort
• quality
• timely results

endoscopy global rating scale
www.grs.nhs.uk
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Quality assurance - organisations

• Peer review visits
• Validate GRS
• Assess the training environment and
  infrastructure
• Assess other processes (eg decontamination)

JAG accreditation