Cholecystectomy Quality Improvement Collaborative (Chole-QuIC)
Gallstone-related diseases account for approximately one-third of emergency general surgery admissions and referrals and there is wide variation in the management of these patients, with cholecystectomy rates within 10 days of first admission for acute cholecystitis ranging from 0% to 35% across England. For this reason, RCS England developed the Chole-QuIC collaborative, a nationwide project that focuses on improving the quality of care for patients with acute gallstone disease.
The projects aim to improve outcomes for patients with gallstone disease by reducing variation and reducing time to surgery by using quality improvement (QI) methodology to empower clinicians to drive change within their own hospital trusts.
Chole-QuIC was launched in 2016 and was followed by CholeQuIC-ER and Chole-QuIC3. You can find out more about each of these collaboratives below, or visit our HandsFirst QI Collaborative page to find out about our newest quality improvement project.
What are the benefits of joining a QI Collaborative?
- Support from clinical and QI experts through coaching sessions, email support and teleconferences.
- Access to a local data platform.
- Peer collaboration with colleagues at participating sites.
- Attendance at webinars and collaborative events.
- Specially designed programme to meet your trust or health board’s specific needs.
- The opportunity to improve emergency gallstone pathways, relieve pressure on the system and save your service money.
Methodology
Chole-QuIC
The goal of Chole-QuIC was for 80% of eligible*, admitted patients to receive their cholecystectomy within 8 days of presentation at the hospital, in line with NICE guidance 3. The project launched in October 2016 and closed in January 2019, with 13 participating hospitals. Watch the video below to discover more about Chole-QuIC.
*Patients with acute biliary pain/cholecystitis or gallstone pancreatitis who are assessed as medically fit for surgery and choose to have surgery on an urgent basis.
Evaluation publications
Our evaluation papers (listed below) demonstrate that participating hospitals substantially improved outcomes for patients by significantly reducing the time to surgery for patients needing an emergency cholecystectomy. Read the related press release.
- Understanding the influences on successful quality improvement in emergency general surgery: learning from the RCS Chole-QuIC project - Implementation Science.
- Effectiveness of a quality improvement collaborative
in reducing time to surgery for patients requiring emergency cholecystectomy - BJSOpen.
You can learn more about the lessons from the project in the RCS Bulletin.
- Site Lead blog: read more about the project from a site lead's point of view in Nabeel Qureshi's blog.
- Clinical lead blog: read about the project from the perspective of Ian Beckingham, Clinical Lead for the project.
CholeQuIC-ER
CholeQuIC-ER launched in July 2019 and reached its conclusion in December 2020. The project worked with 22 trusts and health boards across the UK to radically improve outcomes for their patients with gallstone disease by implementing and expanding the learning from Chole-QuIC.
Project findings show that the full CholeQuIC-ER cohort improved their eight-day surgery rate and average time to surgery during the collaborative period.
The majority of CholeQuIC-ER sites also improved their eight-day surgery ranking, with one site climbing 81 places. The top two sites for eight-day rates across England and Wales are now held by CholeQuIC-ER participants.
Chole-QuIC3
We launched our third Cholecystectomy Quality Improvement Collaborative 3 (Chole-QuIC3) in April 2021 and this project closed in July 2022. This project offered the opportunity for trusts/health boards across the UK to dramatically improve outcomes for patients with gallstone disease.
Read the Achieving and sustaining improvements in gallstone improvement collaboratives article in the November 2022 edition of the RCS England Bulletin.
Join Chole-QuIC4.
In late 2023 we launched the Cholecystectomy Quality Improvement Collaborative 4 (Chole-QuIC4) project.
The project will use proven Quality Improvement methods and offer ongoing support to clinicians and managers to drive improvements in their hospitals. Each site will be given tailored support to make improvements depending on their local context and unique set of challenges. For sites that already have excellent eight-day surgery rates, the focus will be on 'sustaining excellence'.
What are the benefits?
- Support from clinical and QI experts through coaching sessions, email support and teleconferences.
- Access to a local data platform.
- Peer collaboration with colleagues at participating sites.
- Attendance at webinars and collaborative events.
- Specially designed programme to meet your trust or health board’s specific needs.
- The opportunity to improve emergency gallstone pathways, relieve pressure on the system and save your service money.
Participating sites
• Basildon and Thurrock University Hospitals NHS Foundation Trust
• Bradford Teaching Hospitals NHS Foundation Trust
• Cwm Taf Morgannwg University Health Board
• East Sussex Healthcare NHS Trust
• Frimley Health NHS Foundation Trust
• Lancashire Teaching Hospitals NHS Foundation Trust
• North Bristol NHS Trust (Southmead Hospital)
• Northern Devon Healthcare NHS Trust
• Plymouth Hospitals NHS Trust
• Sherwood Forest Hospitals NHS Foundation Trust
• University Hospitals Birmingham NHS Foundation Trust
• University Hospitals Coventry and Warwickshire NHS Trust
CholeQuIC-ER
• Aneurin Bevan University Health Board
• Belfast Health and Social Care Trust
• Brighton and Sussex University Hospitals NHS Trust
• Cardiff & Vale University Health Board
• Croydon Health Services NHS Trust
• Cwm Taf Morgannwg University Health Board
• Dartford and Gravesham NHS Trust
• East Lancashire Hospitals NHS Trust
• Great Western Hospitals NHS Foundation Trust
• Imperial College Healthcare NHS Trust
• Kingston Hospital NHS Foundation Trust
• Manchester University NHS Foundation Trust
• North Cumbria University Hospitals NHS Trust
• North Middlesex University Hospital NHS Trust
• Royal Devon and Exeter NHS Foundation Trust
• Royal Free London NHS Foundation Trust
• Royal Surrey County Hospital NHS Foundation Trust
• The Dudley Group NHS Foundation Trust
• The Royal Bournemouth and Christchurch NHS Foundation trust
• United Lincolnshire Hospitals NHS Trust
• University Hospitals of North Midlands NHS Trust
• Wrightington, Wigan And Leigh NHS Foundation Trust
Chole-QuIC3
• Bedfordshire Hospitals NHS Foundation Trust Luton & Dunstable
• Belfast Health and Social Care Trust
• Cwm Taf Morgannwg University Health Board
• East Lancashire Hospitals NHS Trust
• James Paget University Hospital NHS Trust
• Liverpool University Hospitals NHS Foundation Trust
• Mid And South Essex NHS Foundation Trust
• North Cumbria University Hospitals NHS Trust
• Royal Free London NHS Foundation Trust
• The Royal Bournemouth and Christchurch NHS Foundation trust
• The Whittington Health NHS Trust
• University Hospitals Bristol And Weston NHS Foundation Trust
References
2. SWORD database: http://www.augis.org/sword/
3. National Institute for Health and Care Excellence, 2015, Gallstone disease: Quality standard (QS104): https://www.nice.org.uk/guidance/qs104
4. See the Institute of Healthcare Improvement’s Breakthrough Series Collaborative work for more information
5. Improvement collaboratives in healthcare, Health Foundation, 2013: http://www.health.org.uk/publication/improvement-collaboratives-health-care
More information
For additional information, please contact:Sheena MacSween, Project Manager
Email: cholequic@rcseng.ac.uk
Phone: 020 7869 6264