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  • Measure Summary
  • NQMC:010945
  • Dec 2014

Diagnostic flexible bronchoscopy: proportion of patients who are managed according to the trust's sedation policy.

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 patients who are managed according to the trust's sedation policy.

Rationale

In 2008, the National Patient Safety Agency published a rapid response report to address concerns and make recommendations to reduce sedation related adverse events. More recently, the United Kingdom (UK) Department of Health has identified overdose of midazolam during conscious sedation as one of the top ten "never events" for 2012/2013.

The Francis Report (Mid Staffordshire NHC Foundation Trust Public Inquiry, 2013) defines an integrated hierarchy of fundamental standards that all health care trusts and workers should implement and practice to ensure the safety and wellbeing of all patients.

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]

Department of Health. The “never events” list 2012/13. London (UK): National Health Service (NHS); 2012 Jan. 19 p.

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

Mid Staffordshire NHC Foundation Trust Public Inquiry. Report of the Mid Staffordshire NHC Foundation Trust Public Inquiry. Final report. London (UK): Mid Staffordshire NHC Foundation Trust Public Inquiry; 2013 Feb 6.

National Patient Safety Agency (NPSA). Reducing risk of overdose with midazolam injection in adults. London (UK): National Health Service (NHS); 2008 Dec 9. 1 p.  (Rapid Response Report; no. 11).

Primary Health Components

Flexible bronchoscopy; safe sedation policy

Denominator Description

The number of bronchoscopy procedures performed

Numerator Description

The number of patients having a bronchoscopy that are managed according to a safe sedation policy (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

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
Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

Staying Healthy

IOM Domain

Effectiveness

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 bronchoscopy procedures performed

Exclusions
Unspecified

Exclusions/Exceptions

Unspecified

Numerator Inclusions/Exclusions

Inclusions
The number of patients having a bronchoscopy that are managed according to a safe sedation policy

Note:

  • Refer to Appendix 3 of the original measure documentation for a list of drugs used in bronchoscopy.
  • Refer to Appendix 4 of the original measure documentation for the levels of safe sedation, Ramsay Scale (RS), and Modified Observer's Assessment of Alertness/Sedation (MOAAS) scale.

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

Unspecified

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 2c.

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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