PTH-012 Implementation of UK acute upper GI bleeding bundle results in significant improvements in quality standards

IntroductionThe 2015 NCEPOD report ‘Time to Get Control’ highlighted the need to improve the quality of care of patients with acute upper GI bleeding (AUGIB). The BSG Endoscopy Quality Improvement Project created an evidence based care bundle for AUGIB targeting ward based management of patients within the first 24 hours (The UK AUGIB bundle). The impact of implementation of the UK AUGIB bundle has not been assessed in clinical practice.MethodsAn audit of the impact of the UK AUGIB bundle was undertaken in 15 Scottish hospitals on behalf of the Scottish Society of Gastroenterology. Data were collected relating to demographics and management of patients with AUGIB within the first 24 hours of presentation, for a six-week period pre- and post-implementation of the UK AUGIB bundle. A period of bundle promotion was undertaken in all centres between the data collection cycles. Outcome measures included documentation of bundle implementation, risk scores and transfusion strategy. Caldicott approval was obtained in each site.ResultsA total of 459 patients were included in the pre-bundle audit period, and 434 patients in the post-bundle audit period. Following implementation the AUGIB bundle was utilised in 41.2% of patients. The table 1 demonstrates patient demographics and the impact of bundle implementation.Abstract PTH-012 Table 1Variable Pre-bundle period p-value Post-bundle period Bundle not used p-value Bundle used DEMOGRAPHIC VARIABLES Number of patients 459 (51.4%) n/a 434 (48.6%) 205 (53.4%) n/a 179 (46.6%) Age (years) 64.7 [63.0–66.4] 0.772 64.4 [62.7–66.0] 65.8 [63.4–68.1] 0.043 62.2 [59.5–64.8] MaleFemale 264 (57.8%)193 (42.2%) 0.530 266 (61.4%)167 (38.6%) 123 (60.0%)82 (40.0%) 0.395 113 (63.1%)66 (36.9%) GBS score 6.3 [0-–19] 0.011 7.4 [0–20] 7 [0–18] 0.141 8.0 [0–20] Varices 27 (7.3%) 0.007 51 (13.3%) 24 (13%) 0.733 24 (14%) BUNDLE VARIABLES Blatchford (GBS) recorded 163 (38.4%)