title: Benchmarking patient experiences in colonoscopy using the Global Rating Scale.
abstract: BACKGROUND
  The Global Rating Scale (GRS) is a quality assurance program that was developed in England to assess patient-centered care in endoscopy. The aim of the current study was to evaluate patient experiences of colonoscopy using the GRS in order to compare different departments and to provide benchmarks. The study also evaluated factors associated with patient satisfaction.
  
  
  METHODS
  A GRS questionnaire was used both before and after the procedure in outpatients undergoing colonoscopy. The questionnaire assessed the processes associated with the colonoscopy, from making the appointment up until discharge. Mean values and ranges of 12 endoscopy departments were calculated together with P values in order to assess heterogeneity.
  
  
  RESULTS
  In total, 1904 pre-procedure and 1532 (80 %) post-procedure questionnaires were returned from 12 endoscopy departments. The mean time patients had to wait for their procedure was 4.3 weeks (range 3.1 - 5.8 weeks), and 54 % (range 35 - 64 %; P < 0.001) reported being given a choice of appointment dates/times. Discomfort during colonoscopy was reported by 20 % (range 8 - 40 %; P < 0.001). Recovery room privacy was satisfactory for 76 % of patients (range 66 - 90 %; P < 0.05). The majority of patients reported being sufficiently informed about what to do in case of problems after discharge (79 %, range 43 - 98 %; P < 0.001), and 85 % of individuals stated that they would be willing to repeat the colonoscopy procedure (range 72 - 92 %; P < 0.001). Factors associated with a decreased willingness to return were the burdensome bowel preparation (odds ratio [OR] = 0.25; P < 0.001), "rushing staff" attitude (OR = 0.57; P < 0.05), low acceptance of the procedure (OR = 0.42; P < 0.01), and more discomfort than expected (OR = 0.54; P < 0.05).
  
  
  CONCLUSIONS
  Overall patient experiences with colonoscopy were satisfactory, but they also showed considerable variation. This study shows that use of a GRS patient questionnaire is feasible in the Dutch endoscopy setting for the assessment of patient experience. The significant variability between endoscopy units can be used to benchmark services and enable shortcomings to be identified.
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. j.sintnicolaas@erasmusmc.nl
authors.forename: J
authors.initials: J
authors.lastname: Sint Nicolaas
authors.forename: V
authors.initials: V
authors.lastname: de Jonge
authors.forename: I J
authors.initials: IJ
authors.lastname: Korfage
authors.forename: F
authors.initials: F
authors.lastname: Ter Borg
authors.forename: J T
authors.initials: JT
authors.lastname: Brouwer
authors.forename: D L
authors.initials: DL
authors.lastname: Cahen
authors.forename: W
authors.initials: W
authors.lastname: Lesterhuis
authors.forename: R J Th
authors.initials: RJ
authors.lastname: Ouwendijk
authors.forename: E J
authors.initials: EJ
authors.lastname: Kuipers
authors.forename: M E
authors.initials: ME
authors.lastname: van Leerdam
mesh_terms: D019985:Benchmarking; D003113:Colonoscopy; D005260:Female; D006748:Hospital Departments; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D011785:Quality Assurance, Health Care; D011795:Surveys and Questionnaires