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  • Measure Summary
  • NQMC:010944
  • Dec 2014

Diagnostic flexible bronchoscopy: proportion of bronchoscopy procedures performed with a completed safety checklist.

British Thoracic Society (BTS). Quality standards for diagnostic flexible bronchoscopy in adults. London (UK): British Thoracic Society (BTS); 2014 Dec. 37 p.  (British Thoracic Society Reports; no. 5). [28 references]

View the original measure documentation External Web Site Policy

This is the current release of the measure.

Primary Measure Domain

Clinical Quality Measures: Process

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the proportion of bronchoscopy procedures performed with a completed safety checklist.

Rationale

In 2009 the National Patient Safety Agency published an alert for healthcare organisations to use the World Health Organisation (WHO) Surgical Safety Checklist in any operating theatre environment.

In June 2008, WHO launched a second Global Patient Safety Challenge, "Safe Surgery Saves Lives," to reduce the number of surgical deaths across the world. The safety checklist is part of this initiative.

The checklist divides the procedure into two phases, each corresponding to a specific time period in the normal flow of a procedure;

  • The period before the procedure starts or sedation is given
  • The period during or immediately after the procedure is completed, but before taking the patient out of the procedure room

Nearly all the steps are checked verbally (by the bronchoscopist/nurse in charge) with the appropriate personnel to ensure that key actions have been performed and are indicated on the checklist.

The checklist co-ordinator (bronchoscopist) and nurse in charge both take responsibility to ensure the checklist is completed in full before the patient moves to the recovery area.

Endoscopy teams should seek to incorporate use of the checklist into their work with maximum efficiency and minimum disruption, while aiming to accomplish the steps in a timely and effective manner.

Organisations are required to:

  • Ensure an executive and a clinical lead is identified in order to implement the safety checklist within the organisation
  • Ensure the checklist is completed for every patient undergoing a surgical procedure, including procedures under sedation and local anaesthesia
  • Ensure that a registered member of the team enters the checklist in the clinical notes or electronic record of each patient

The British Thoracic Society (BTS) guideline for diagnostic flexible bronchoscopy in adults (Du Rand et al., 2013) and the BTS guideline for advanced diagnostic and therapeutic flexible bronchoscopy in adults (Du Rand et al., 2011) are the main references for the quality standards.

Evidence for Rationale

British Thoracic Society (BTS). Quality standards for diagnostic flexible bronchoscopy in adults. London (UK): British Thoracic Society (BTS); 2014 Dec. 37 p.  (British Thoracic Society Reports; no. 5). [28 references]

Du Rand IA, Barber PV, Goldring J, Lewis RA, Mandal S, Munavvar M, Rintoul RC, Shah PL, Singh S, Slade MG, Woolley A, British Thoracic Society Interventional Bronchoscopy Guideline Group. British Thoracic Society guideline for advanced diagnostic and therapeutic flexible bronchoscopy in adults. Thorax. 2011 Nov;66(Suppl 3):iii1-21. [131 references] PubMed External Web Site Policy

Du Rand IA, Blaikley J, Booton R, Chaudhuri N, Gupta V, Khalid S, Mandal S, Martin J, Mills J, Navani N, Rahman NM, Wrightson JM, Munavvar M, British Thoracic Society Bronchoscopy Guideline Group. British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults. Thorax. 2013 Aug;68(Suppl 1):i1-44. [303 references] PubMed External Web Site Policy

World Health Organisation (WHO). Surgical safety checklist. Geneva (Switzerland): World Health Organisation (WHO); 2009 Jan. 1 p.

Primary Health Components

Flexible bronchoscopy; safety checklist

Denominator Description

The number of procedures done

Numerator Description

The number of safety checklists completed (see the related "Numerator Inclusions/Exclusions" field)

State of Use

Current routine use

Current Use

Internal quality improvement

Measurement Setting

Ambulatory Procedure/Imaging Center

Hospital Inpatient

Hospital Outpatient

Professionals Involved in Delivery of Health Services

Advanced Practice Nurses

Nurses

Physician Assistants

Physicians

Least Aggregated Level of Services Delivery Addressed

Single Health Care Delivery or Public Health Organizations

Statement of Acceptable Minimum Sample Size

Unspecified

Target Population Age

Adults

Target Population Gender

Either male or female

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Health and Well-being of Communities
Making Care Safer

IOM Care Need

Staying Healthy

IOM Domain

Safety

Case Finding Period

Unspecified

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Diagnostic Evaluation

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
The number of procedures done

Exclusions
Unspecified

Exclusions/Exceptions

Unspecified

Numerator Inclusions/Exclusions

Inclusions
The number of safety checklists completed

Note: Refer to Appendix 2 of the original measure documentation for the British Thoracic Society (BTS) Flexible Bronchoscopy Safety Checklist (adapted from the World Health Organisation [WHO] Surgical Safety Checklist).

Exclusions
Unspecified

Numerator Search Strategy

Fixed time period or point in time

Data Source

Administrative clinical data

Type of Health State

Does not apply to this measure

Instruments Used and/or Associated with the Measure

British Thoracic Society (BTS) Flexible Bronchoscopy Safety Checklist (adapted from the World Health Organisation [WHO] Surgical Safety Checklist)

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Rate/Proportion

Interpretation of Score

Desired value is a higher score

Allowance for Patient or Population Factors

Unspecified

Standard of Comparison

Internal time comparison

Original Title

Quality statement 2b.

Measure Collection Name

Quality Standards for Diagnostic Flexible Bronchoscopy in Adults

Submitter

British Thoracic Society - Medical Specialty Society

Developer

British Thoracic Society - Medical Specialty Society

Funding Source(s)

British Thoracic Society

Composition of the Group that Developed the Measure

A Quality Standards Working Group was convened in September 2013, with the following membership:

  • Dr Ingrid Du Rand, Co-Chair, consultant respiratory physician, Hereford
  • Dr M Munavvar, Co-Chair, consultant respiratory physician, Preston
  • Dr Jonathan Bennett, consultant respiratory physician, Leicester
  • Dr John Blaikley, senior lecturer and honorary consultant respiratory physician, Manchester
  • Dr Richard Booton, consultant respiratory physician, Manchester
  • Dr Nazia Chaudhuri, consultant respiratory physician, Manchester
  • Dr James Finnerty, consultant respiratory physician, Chester
  • Dr Vandana Gupta, specialist registrar in respiratory medicine, Manchester
  • Dr Saifudin Khalid, consultant respiratory physician, Blackburn
  • Dr Swapna Mandal, specialist registrar in respiratory medicine, London
  • Ms Julie Martin, respiratory nurse consultant, Manchester
  • Mrs Anne McCloy, lay representative
  • Ms Janet Mills, respiratory nurse, Preston
  • Dr Neal Navani, consultant respiratory physician, London
  • Dr Najib Rahman, consultant respiratory physician, Oxford
  • Dr John Wrightson, consultant respiratory physician, Oxford

Financial Disclosures/Other Potential Conflicts of Interest

Members of the Quality Standards Group submitted Declaration of Interest forms in line with the British Thoracic Society (BTS) policy and copies of forms are available online via the BTS Web site External Web Site Policy or on request from the BTS Head Office.

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2014 Dec

Measure Maintenance

The Quality Standards document will be reviewed in 2018 or following the publication of a revised guideline, whichever is the sooner.

Date of Next Anticipated Revision

2018

Measure Status

This is the current release of the measure.

Source(s)

British Thoracic Society (BTS). Quality standards for diagnostic flexible bronchoscopy in adults. London (UK): British Thoracic Society (BTS); 2014 Dec. 37 p.  (British Thoracic Society Reports; no. 5). [28 references]

Measure Availability

Source available from the British Thoracic Society (BTS) Web site External Web Site Policy.

For more information, contact BTS at 17 Doughty St, London, WC1N 2PL; Tel: ++ 44 (0) 20 7831 8778; Fax: ++ 44 (0) 20 7831 8766; E-mail: bts@brit-thoracic.org.uk; Web site: www.brit-thoracic.org.uk External Web Site Policy.

NQMC Status

This NQMC summary was completed by ECRI Institute on November 15, 2016. The information was verified by the measure developer on January 4, 2017.

Copyright Statement

This NQMC summary is based on the original measure, which is subject to the measure developer's copyright restrictions.

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