MEMBERS:

Dr. Daniel Steinfort (Chair)

BACKGROUND:

Optimal procedural performance of EBUS is well described, with publication of multiple guidelines and expert reviews. This addresses individual proceduralist factors, but does not examine system-level characteristics which may impact quality more so than just procedural competence. The concept of Quality incorporates more extensive consideration of service delivery and includes pre-procedural, intra-procedural and post-procedural aspects of the procedure. Quality assessment is integral in ensuring optimal clinical effectiveness of any intervention.

The British Thoracic Society published in 2014 their guidelines for Quality Standards for diagnostic flexible bronchoscopy in which they propose standards of care that should be met for flexible bronchoscopy procedures in the UK, together with measurable markers of good practice. This has not been updated

Quality indicators should be measurable, and can be incorporated into standard procedural reporting - Standardized reporting elements are important for monitoring quality and promoting adherence to established targets. Improved patient outcomes and efficiency of care have been shown when procedural reporting is consistent.

PROPOSAL:

A taskforce to examine quality indicators for performance of EBUS

AIMS:

• To review the evidence for each indicator in ensuring optimal quality/effectiveness of EBUS.
• To identify areas for future research to further improve consistent optimal performance/effectiveness of EBUS

METHODS:

1. A comprehensive literature search and review to identify EBUS quality indicators and key components of high-quality standardized EBUS reporting.
2. Development of recommendations for Quality Standards Indicators (as per Guyatt 2002) to be routinely recorded (i.e. standard reporting elements), including priority indicators (quality indictors where reaching the recommended performance target is considered strongly associated with important clinical outcomes. These indicators can be measured readily in a manageable number of examinations, and for each there is evidence of substantial variation in performance)

APPLICATION FORM: