P16 Acceptability of key performance indicators (KPI) in the national endoscopy database (NED), a delphi process

Background and study aims Colonoscopists with low polyp detection have higher post colonoscopy colorectal cancer incidence and mortality rates. The United Kingdom’s National Endoscopy Database (NED) automatically captures patient level data in real time and provides endoscopy key performance indicators (KPI) at a national, endoscopy center, and individual level. Using an electronic behavior change intervention, the primary objective of this study is to assess if automated feedback of endoscopist and endoscopy center-level optimal procedure-adjusted detection KPI (opadKPI) improves polyp detection performance.Methods This multicenter, prospective, cluster-randomized controlled trial is randomizing NHS endoscopy centres to either intervention or control. The intervention is targeted at independent colonoscopists and each center’s endoscopy lead. The intervention reports are evidence-based from endoscopist qualitative interviews and informed by psychological theories of behavior. NED automatically creates monthly reports providing an opadKPI, using mean number of polyps, and an action plan. The primary outcome is opadKPI comparing endoscopists in intervention and control centers at 9 months. Secondary outcomes include other KPI and proximal detection measures at 9 and 12 months. A nested histological validation study will correlate opadKPI to adenoma detection rate at the center level. A cost-effectiveness and budget impact analysis will be undertaken.Conclusion If the intervention is efficacious and cost-effective, we will showcase the potential of this learning health system, which can be implemented at local and national levels to improve colonoscopy quality, and demonstrate that an automated system that collects, analyses, and disseminates real-time clinical data can deliver evidence- and theory-informed feedback.

Introduction The UK National Endoscopy Database (NED) Project will enable prospective automatic data collection from endoscopy reporting systems in individual hospitals to a national database. Comprehensive national endoscopy data is vital for quality assurance, benchmarking, audit and research. Once fully deployed NED will accept 1 million procedures per year from over 300 hospitals. Methods The National Endoscopy Database is based on the successful JAG Endoscopy Training System (JETS). It has been developed to gather data for calculation of key performance indicators (KPIs) for OGD, flexible sigmoidoscopy, colonoscopy and ERCP. All the major endoscopy reporting system (ERS) manufacturers have engaged with the project and are modifying their systems to allow a mandatory minimum dataset to be automatically uploaded to a central database. The new data schema terms are based on MST 3.0 allowing mapping to a standardised terminology. Results Testing of the upload methodology has demonstrated it is secure, robust, scalable and accurate. To date, two of the major ERS manufacturers have implemented NED compatible software at designated pilot sites. Pilot testing is ongoing. Further roll out and pilot testing is planned over forthcoming months. Conclusion Initial results from the NED project demonstrate that the proposed upload methodology is reliable and accurate. Modifications to existing ERS are currently being performed by all major manufacturers and testing of uploading real time clinical data underway. The ability to centrally collect endoscopy performance data will be an invaluable tool for monitoring and improving endoscopy quality and will provide a platform for endoscopy research. Disclosure of Interest None Declared

IntroductionThe UK National Endoscopy Database (NED) is a JAG-led informatics project centred on the extraction of data from endoscopy reporting systems (ERS) in participating units to a centralised database. The...

Background and study aimsHigh-quality is crucial for the effectiveness of colonoscopy and can be achieved by high-quality training and verified with assessment of key performance indicators (KPIs) for colonoscopy such as cecum intubation rate (CIR), adenoma detection rate (ADR) and adequate polyp resection. Typically, trainees achieve adequate CIR after 275 procedures, but little is known about learning curves for KPIs after initial training.MethodsThis cross-sectional study includes work-up colonoscopies after a positive screening test with fecal occult blood testing (FIT) or sigmoidoscopy, performed by either trainees after 300 training colonoscopies or by consultants. Outcome measures were KPIs. We assessed inter-endoscopist variation in trainees and learning curves for trainees as a group. We also compared KPIs for trainees and consultants as a group. ResultsData from 6,655 colonoscopies performed by 21 trainees and 921 colonoscopies performed by 17 consultants were included. Most trainees achieved target standards for main KPIs. With time, trainees shortened cecum intubation time and withdrawal time without decreasing their ADR, reduced the proportion of painful colonoscopies, and increased the adequate polyp resection rate (allP < 0.01). Compared to consultants, trainees had higher CIR (97.7 % vs. 96.3 %,P = 0.02), ADR after positive FIT (57.6 % vs. 50.3 %,P < 0.01), and proximal ADR after sigmoidoscopy screening (41.1 % vs. 29.8 %;P < 0.01), higher adequate polyp resection rate (94.9 % vs. 93.1 %,P = 0.01) and fewer serious adverse events (0.65 % vs. 1.41 %,P = 0.02).ConclusionsTrainees performed high-quality colonoscopies and achieved international target standards. Several KPIs continuously improved after initial training. Trainees outperformed consultants on several KPIs.

IntroductionMonitoring of key performance indicators (KPIs) is paramount to standardise and improve quality in endoscopy. Adenoma detection rate (ADR) is considered the best surrogate marker for colonoscopic diagnostic accuracy, having...

In order to measure the smartness of a city, international standardization bodies have standardized Key Performance Indicators (KPIs). While the smart city concept holds great promise of better utilization of scarce resources, the unavailability of real-world open data on cities statistics hardens the evaluation of its key performance indicator. Mashhad is the first city in Iran which undergo the United for Smart Sustainable Cities (U4SSC) program in KPI verification process. By standardized assessment and evaluation of KPI as an indicator of smartness, Mashhad has progressed to propose its strategy and roadmap toward a smart city and find the ability to measure its progress based on the measured KPIs. In order to measure these KPI Mashhad had some challenges and experience to obtain this information. This paper presents international standard initiatives on smart cities evaluation and investigates the case study of Mashhad experience and challenge in KPI verification process.

This study aims to contribute to the literature by conducting a conceptual research on the important issues of customer satisfaction, financial stability, brand loyalty and increasing efficiency by performing (Key Performance Indicator) KPI measurements with the integration of technology in the field of logistics. This study is designed as a conceptual literature review aiming to evaluate the use of Key Performance Indicators (KPIs) in the logistics sector. No field research, surveys, or primary data collection processes were conducted in this study. The findings are based on a systematic analysis of the existing academic literature. The literature review was structured in accordance with the defined research objective. In this context, studies focusing on logistics performance measurement, KPI systems, and the relationship between productivity and financial performance were examined. The review process was carried out using national and international academic databases. The selected studies were analyzed using content analysis. In the analysis process, the effects of KPI systems on logistics processes were classified within the framework of productivity and financial performance dimensions. The findings are interpreted conceptually in the discussion section. It was concluded that positive evaluations can be achieved in the logistics sector as a result of the use of the (Key Performance Indicator) KPI system and that it will contribute to the field when the necessary adjustments are made. This study will provide important indicators for businesses in making decisions as a result of the (Key Performance Indicator) KPI evaluations to be applied on ıncreasing customer satisfaction, financial stability, brand loyalty and efficiency in the field of logistics.

In response to large-scale health crises, emergency healthcare infrastructure projects (EHIPs) have been implemented to provide healthcare services rapidly. However, few studies have systematically explored the success of these projects. This study aims to assess the success of EHIPs throughout the whole life cycle using a cloud matter-element model (CMEM). Considering multiple performance indicators that measure the success of EHIPs, a hierarchy model of the project success index is proposed through eight rounds of Delphi surveys. This model comprises 10 key performance indicators (KPIs) that are most appropriate for measuring the success of EHIPs and 20 quantitative metrics aligned with these KPIs across the life cycle. Based on the hierarchy model, the CMEM is applied to evaluate the success of EHIPs, which effectively addresses the fuzziness and randomness inherent in the Delphi process. Two cases were then utilized for verifying the practicality of the proposed project success assessment model. The findings demonstrate that the CMEM-based assessment offers not only significant flexibility but also high accuracy, robustness, and scalability. The CMEM-based assessment seamlessly integrates numerous incompatible indexes and their characteristic values, without being limited by the number of evaluation indexes. Further, sensitivity analyses are conducted to test the robustness of the assessment model and its results. These analyses confirmed that the CMEM is a robust, reliable, and adaptable tool for assessing the success of EHIPs. Theoretically, this study should set an exemplar of aggregating the performance measurement with emergency management and healthcare systems, facilitating an efficient response to major crises. It also provides a novel approach to evaluating multiple-criteria decision-making problems. Practically, this study should enable project management teams to identify and improve weak areas, ensuring continuous success in the EHIP-related domain.

IntroductionThe EndoringsTM is a distal attachment consisting of two layers of circular flexible rings that evert mucosal folds. Aims; to investigate if Endorings Colonoscopy (ER) improves polyp and adenoma detection...

Purpose – The purpose of this paper is to identify and assess the key performance indicators (KPIs) for the maintenance of public hospital buildings in the Gaza Strip. Design/methodology/approach – Four KPIs were identified and evaluated in this paper: building performance indicators (BPI), maintenance efficiency indicators (MEI), annual maintenance expenditure (AME) and urgent repair request indicator. Twenty-one buildings in 13 public hospitals in Gaza Strip Governorate were taken as the sample of this study. Findings – The results indicated that the European Gaza hospital has the highest BPI score (81.66) and the Dorra hospital has the lowest BPI score (68.26). The findings revealed that the average AME for all hospitals was $13.8/m2 which is considered to be below the standard level of expenditure. The MEI for Gaza public hospital buildings was found to be equal to 0.3 which indicated low level of maintenance expenditure. Research limitations/implications – Unavailability of certain data, lack of maintenance documentation and comparison difficulty between the Gaza Strip and Israel due to political, cultural and financial situation were some of the limitations of this study. Practical implications – The Ministry of Health (MoH) can utilize the results of this study and consider it as benchmarking for maintenance management in public hospital buildings. This can improve the current maintenance situation which ultimately will improve the health-care situation in Palestine. The Palestinian MoH should look for external funding to increase the AME, as well as aim at increasing the MEI. Social implications – The health-care situation in Palestine will be improved. Originality/value – This study is considered the first study to identify and assess the KPIs in the Gaza Strip. KPIs will assist the MoH to compare the actual and estimated performance in terms of effectiveness, efficiency and quality of workmanship.

BackgroundHigh-quality colonoscopy is crucial to ensure complete mucosal visualisation and to maximise detection of pathology. Previous audits showing variable quality have prompted national and international colonoscopy improvement programmes, including the...

<h3>Introduction</h3> Colonoscopy remains the gold standard procedure for screening and polyp detection, with adenoma detection rate (ADR) being a widely-accepted key performance indicator (KPI). It has long been recognised that even experienced endoscopists incur an appreciable ‘miss-rate’ and a number of novel devices have been marketed to assist this aspect of practice. The Endorings™ device is a simple soft silicone, single-use device consisting of a series of rings arranged around a central tubular core. As the colonoscope is inserted the rings fold backward to allow intubation and flare on withdrawal to flatten colonic folds and aid inspection. <h3>Methods</h3> Prospective data was collected during screening colonoscopy (performed by two accredited colonoscopists) when the Endorings™ device was used and compared the KPI results to outcomes from the previous few months, for the same two colonoscopists) when the device was not in use (ie. historical controls). <h3>Results</h3> The ADR without Endorings™ (n = 85) was 49.4% with a per-procedure detection rate (ppr) of 0.97. With Endorings (n = 66) 66.7% (p = 0.0006) with ppr of 1.625. This represents a 35% increase in ADR and a 68% increase in the number of polyps detected at any given procedure. There were no significant differences in completion rates, withdrawal time, use of sedation or comfort scores. The device was removed in 5/66 procedures due to interference with intubation (in the presence of either an angulated sigmoid or diverticulosis). No complications were recorded. <h3>Conclusion</h3> Use of the Endorings™ device was associated with a significant increase in ADR. Qualitatively, the three-ring design was felt to interfere with normal intubation such that insertion technique had to be modified. An updated design iteration with two rings in slightly different positions along the central tube, has been produced and appears to offer a significant advantage in this regard. Furthermore, the central tube can be pushed further along the distal end of the colonoscope to allow the terminal ileum to be intubated with the device in place. The Endorings™ may offer an advantage in screening colonoscopy and, in this cohort, further prospective investigation is warranted. <h3>Disclosure of Interest</h3> None Declared

Public dental organizations require effective and evidence-based support for clinical and business decision-making. A pilot business intelligence system has been proposed for a public dental service in New South Wales, Australia, to aid with this decision-making. To inform the design and development of this system, we aim to identify the key performance indicators and report features perceived to be the most valuable to the dental service decision-makers. A self-administered survey employing best-worst scaling with balanced incomplete block designs was sent to all eligible decision-makers in a Local Health District public dental service in New South Wales, Australia. Participants ranked seven areas of information and five report features. Quantitative rankings were complemented with free-text comments. Nine of the possible 12 participants (75%) completed the survey. The results reported "Patient demand" as the most important area of information for inclusion in the business intelligence system, with "patient demographics" ranked the lowest. For report features, the most important features were reported to be "readability" and "level of detail". All participants reported that they were expected to use computerized reports as part of their role, with four (44%) participants reporting accessing computerized reports more than 100 times in their previous 30 working days. The novel pilot study applies best-worst scaling for prioritizing key performance indicators among public dental decision-makers at a Local Health District within New South Wales and underscores the established role of computerized reports in decision-making processes. These findings will directly guide the design and implementation of a pilot business intelligence reporting system, aiming to enhance data accessibility and accelerate evidence-based decisions within a public dental service to ultimately enhance service efficiency. Future evaluation will be needed to assess the adoption rates of this system and its impact on operational efficiency and patient care outcomes.

The impact of hyoscine-N-butylbromide on adenoma detection during colonoscopy: meta-analysis of randomized, controlled studies

IntroductionColorectal cancer is a significant health problem, the importance of which will increase substantially in the coming years. Demand for colonoscopy will increase and so will demand for complex polypectomy...