Table 1

Audit standards and associated specific outcomes within the organisational variables

Relevant audit standardSpecific outcomes

  1. Patients with any acute GI bleed should only be admitted to hospitals with 24/7 access to on-site endoscopy, interventional radiology (on-site or covered by a formal network), on-site abdominal surgery, on-site critical care and anaesthesia17

Number of UK hospitals with 24/7 access to flexible sigmoidoscopy and colonoscopy
Proportion of UK hospitals with no provision for out of hours endoscopic therapy for LGIB
Availability of a consultant-led service and the competence of on-call endoscopists at providing therapy at lower GI endoscopy
Availability of out of hours endoscopy nurses
Proportion of UK hospitals with on-site IR or access via an agreed referral pathway and proportion with no arrangements in place
Number of UK hospitals that admit LGIB with no in or out of hours provision for major abdominal surgery
Availability of level 2 and 3 care

  1. Endoscopy lists should be organised to ensure GI bleeds are prioritised17

Availability of defined endoscopy slots for LGIB

  1. There should be a minimum of six interventional radiologists on an out of hours rota22

Mean number of interventional radiologists on an out of hours rota and the number of hospitals covered
Mean number of trained interventional radiology nurses available out of hours

  1. Routine daily input from medicine for the care of older people should be available to patients aged ≥70 admitted under surgical teams23 24

Identification of the specialty teams that admit patients with LGIB
Availability of specialist care for elderly patients

  1. A massive transfusion protocol should be readily available* in all hospitals19 25

Location and dissemination of guidelines on the management of major haemorrhage

  1. Local arrangements should be in place to provide compatible blood urgently for patients with major bleeding19 26

Availability of on-call transfusion laboratory staff

  1. Guidelines on gastrointestinal bleeding should be readily available* in all hospitals17

Location and dissemination of guidelines on the management of GI bleeding

  • *Readily available is defined as provided on the hospital intranet and displayed on the wall in admission units.

  • LGIB, lower gastrointestinal bleeding.