Publications by authors named "Manmeet Matharoo"

8 Publications

  • Page 1 of 1

Diagnostic ileocolonoscopy: getting the basics right.

Frontline Gastroenterol 2020 Oct 27;11(6):484-490. Epub 2020 Mar 27.

Wolfson Endoscopy Unit, St Marks Hospital, Harrow, UK.

Proficient colonoscopy technique that optimises patient comfort while simultaneously enhancing the timely detection of pathology and subsequent therapy is an aspirational and achievable goal for every endoscopist. This article aims to provide strategies to improve colonoscopy quality for both endoscopists and patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/flgastro-2019-101266DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7569527PMC
October 2020

Teamworking in endoscopy: a human factors toolkit for the COVID-19 era.

Endoscopy 2020 10 22;52(10):879-883. Epub 2020 Jun 22.

Department of Surgery and Cancer, Imperial College London, United Kingdom.

Background: Endoscopy services have had to rapidly adapt their working practices in response to COVID-19. As recovery of endoscopy services proceeds, our workforce faces numerous challenges that can impair effective teamworking. We designed and developed a novel toolkit to support teamworking in endoscopy during the pandemic.

Methods: A human factors model was developed to understand the impact of COVID-19 on endoscopy teams. From this, we identified a set of key teamworking goals, which informed the development of a toolkit to support several team processes. The toolkit was refined following expert input and refinement over a 6-week period.

Results: The toolkit consists of four cognitive aids that can be used to support team huddles, briefings, and debriefs, alongside techniques to optimize endoscopic nontechnical skills across the patient-procedure pathway. We describe the processes that local endoscopy units can employ to implement this toolkit.

Conclusion: A toolkit of cognitive aids, based on human factors principles, may be useful in supporting teams, helping them adapt to working safely in the era of COVID-19.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1055/a-1204-5212DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7516366PMC
October 2020

Patient position change in colonoscopy: Dogmatic or pragmatic?

Gastrointest Endosc 2019 06;89(6):1202-1203

The Wolfson Unit for Endoscopy, St. Mark's Hospital, London, Untied Kingdom.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.gie.2019.02.029DOI Listing
June 2019

Safe endoscopy.

Frontline Gastroenterol 2017 Apr 10;8(2):86-89. Epub 2017 Feb 10.

Endoscopy Unit, St Mark's Hospital, Harrow, UK.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/flgastro-2016-100766DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5369442PMC
April 2017

A prospective study of patient safety incidents in gastrointestinal endoscopy.

Endosc Int Open 2017 Jan 17;5(1):E83-E89. Epub 2016 Nov 17.

The Wolfson Unit for Endoscopy, St. Mark's Hospital, Harrow, UK; Department of Surgery and Cancer, Imperial College, London, UK.

 Medical error occurs frequently with significant morbidity and mortality. This study aime to assess the frequency and type of endoscopy patient safety incidents (PSIs).  A prospective observational study of PSIs in routine diagnostic and therapeutic endoscopy was undertaken in a secondary and tertiary care center. Observations were undertaken within the endoscopy suite across pre-procedure, intra-procedure and post-procedure phases of care. Experienced (Consultant-level) and trainee endoscopists from medical, surgical, and nursing specialities were included. PSIs were defined as any safety issue that had the potential to or directly adversely affected patient care: PSIs included near misses, complications, adverse events and "never events". PSIs were reviewed by an expert panel and categorized for severity and nature via expert consensus.  One hundred and forty procedures (92 diagnostic, 48 therapeutic) over 37 lists (experienced operators n = 25, trainees n = 12) were analyzed. One hundred forty PSIs were identified (median 1 per procedure, range 0 - 7). Eighty-six PSIs (61 %) occurred in 48 therapeutic procedures. Zero PSIs were detected in 13 diagnostic procedures. 21 (15 %) PSIs were categorized as severe and 12 (9 %) had the potential to be "never events," including patient misidentification and wrong procedure. Forty PSIs (28 %) were of intermediate severity and 78 (56 %) were minor. Oxygen monitoring PSIs occurred most frequently.  This is the first study documenting the range and frequency of PSIs in endoscopy. Although many errors are minor without immediate consequence, further work should identify whether prevention of such recurrent errors affects the incidence of severe errors, thus improving safety and quality.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1055/s-0042-117219DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292877PMC
January 2017

The endoscopy safety checklist: A longitudinal study of factors affecting compliance in a tertiary referral centre within the United Kingdom.

BMJ Qual Improv Rep 2015 11;4(1). Epub 2015 Feb 11.

UK.

Gastrointestinal endoscopy is a widely used diagnostic and therapeutic procedure both within the United Kingdom and worldwide. With an increasingly older population the potential for complications is increased. The Wolfson Unit for Endoscopy at St. Mark's Hospital in London is a tertiary referral centre, which conducts over 14,000 endoscopic procedures annually. However, despite this high throughput, our baseline observations were that the procedure for safety checks was highly variable. Over a seven-day period we conducted a questionnaire-based survey to all staff members involved with endoscopy within our unit. We found that there was little consensus between team members, both in terms of essential safety checks and designating responsibility for the checks. A panel of experts was convened in order to devise a safety checklist and a strategy for increasing compliance with the checklist among all staff members. Using a combination of electronic and physical reminders and incentives, we found that there was a significant increase in completed checklist (53% to 66%, p = 0.021) and decrease in the number of checklists left blank post intervention (10% to 2%, p=0.03). We believe that post implementation validation of safety checklists is an important method to ensure their proper use.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjquality.u206344.w2567DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4645827PMC
January 2016

Endoscopic non-technical skills team training: the next step in quality assurance of endoscopy training.

World J Gastroenterol 2014 Dec;20(46):17507-15

Manmeet Matharoo, Adam Haycock, Siwan Thomas-Gibson, the Wolfson Unit for Endoscopy, St. Mark's Hospital, Harrow HA1 3UJ, United Kingdom.

Aim: To investigate whether novel, non-technical skills training for Bowel Cancer Screening (BCS) endoscopy teams enhanced patient safety knowledge and attitudes.

Methods: A novel endoscopy team training intervention for BCS teams was developed and evaluated as a pre-post intervention study. Four multi-disciplinary BCS teams constituting BCS endoscopist(s), specialist screening practitioners, endoscopy nurses and administrative staff (A) from English BCS training centres participated. No patients were involved in this study. Expert multidisciplinary faculty delivered a single day's training utilising real clinical examples. Pre and post-course evaluation comprised participants' patient safety awareness, attitudes, and knowledge. Global course evaluations were also collected.

Results: Twenty-three participants attended and their patient safety knowledge improved significantly from 43%-55% (P ≤ 0.001) following the training intervention. 12/41 (29%) of the safety attitudes items significantly improved in the areas of perceived patient safety knowledge and awareness. The remaining safety attitude items: perceived influence on patient safety, attitudes towards error management, error management actions and personal views following an error were unchanged following training. Both qualitative and quantitative global course evaluations were positive: 21/23 (91%) participants strongly agreed/agreed that they were satisfied with the course. Qualitative evaluation included mandating such training for endoscopy teams outside BCS and incorporating team training within wider endoscopy training. Limitations of the study include no measure of increased patient safety in clinical practice following training.

Conclusion: A novel comprehensive training package addressing patient safety, non-technical skills and adverse event analysis was successful in improving multi-disciplinary teams' knowledge and safety attitudes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3748/wjg.v20.i46.17507DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265612PMC
December 2014

Effective teamworking in gastroenterology.

Frontline Gastroenterol 2012 Apr 29;3(2):86-89. Epub 2011 Nov 29.

Wolfson Unit for Endoscopy, St Mark's Hospital, Harrow, UK.

The majority of healthcare provision within the NHS is delivered by teams, but most attempts at improving team functioning are limited to promoting working relationships within the team. This contrasts with other high risk industries, where formalised team training is recognised to be of paramount importance in reducing error. Some medical specialities have adapted such training methodologies with the aim of improving productivity and clinical outcomes. There are many teams within gastroenterology that could benefit from such attention. Formal analysis of team objectives and identification of essential task sequences can allow redesign of team organisation and enable structured training to strengthen team cohesion, enhance critical team skills and improve clinical outcomes. The challenge is to change teams of experts into expert teams.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/flgastro-2011-100048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5517257PMC
April 2012