28 Improving Monitoring and Severity Stratification in Acute Pancreatitis: A Quality Improvement Study Using BISAP Score Implementation

Abstract Aim To evaluate and improve compliance with national guidelines on the monitoring and severity assessment of acute pancreatitis patients, by introducing the BISAP (Bedside Index for Severity in Acute Pancreatitis) scoring system into routine clinical practice. Method A baseline review of case notes was conducted for 30 consecutive patients admitted with acute pancreatitis. Compliance was assessed against NICE and BSG guidelines, focusing on documentation of severity stratification, frequency of observations, and appropriate escalation. A structured intervention was implemented: the BISAP score was introduced via educational sessions and integrated into clerking proformas using the printed format. A re-audit was performed on a subsequent cohort of 30 patients. Results Initial data revealed poor compliance: only 10% of patients had documented severity scores, and regular monitoring was inconsistent, especially in moderate-to-severe cases. Following BISAP implementation, documentation of severity assessment increased to 80%, with improved early identification of high-risk patients. Escalation to higher care was more prompt in severe cases, and overall documentation of fluid balance, observations, and investigations improved significantly. Conclusions Integrating the BISAP score printed format into standard clerking led to a marked improvement in severity documentation and monitoring compliance in acute pancreatitis. This low-cost intervention can help standardise care, facilitate early escalation, and potentially improve patient outcomes.