title: Satisfaction in open access versus traditional referral for upper endoscopy in children.
abstract: OBJECTIVE
  In traditional access endoscopy (TAE), patients are booked for endoscopy following a gastroenterology clinic assessment. In contrast, open access endoscopy (OAE) patients are seen for the first time on the day of the procedure, providing same day procedural consent. Controversy exists over the use of OAE in adults, both with the consent process and with patient satisfaction. No literature exists describing satisfaction with OAE in pediatrics. We therefore aimed to assess pediatric patient and caregiver satisfaction in OAE compared with TAE.
  
  
  METHODS
  Consecutive pediatric patients, and their caregivers, undergoing elective upper endoscopy from May to December 2012 at the Stollery Children's Hospital (Edmonton, Alberta, Canada) were consented for a cross-sectional survey. Seven preprocedure and 5 postprocedure questions were completed regarding mood and satisfaction with the wait time and the information provided. Group demographics and endoscopy wait times were collected.
  
  
  RESULTS
  Median wait time with OAE was less compared with TAE (57 days vs 196 days, P < 0.001). OAE patients reported worse mood preprocedure than TAE patients (35.3% vs 10.7%, P = 0.046). OAE caregivers and patients reported more mood disturbance if required to wait longer for endoscopy by attending clinic preprocedure (OAE caregivers 62.2%, OAE patients 64.7%).
  
  
  CONCLUSIONS
  OAE is associated with worse preendoscopy patient mood; however, children and caregivers seem concerned about longer wait times associated with TAE. Given the significantly shorter wait times in OAE, identifying methods to minimize present limitations of OAE will be useful to improve clinical practices in pediatric gastroenterology.
authors.affiliation: *Division of Pediatrics †Department of Pediatric Gastroenterology & Nutrition, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
authors.forename: Daniela Migliarese
authors.initials: DM
authors.lastname: Isaac
authors.forename: Rabin
authors.initials: R
authors.lastname: Persad
authors.forename: Hien Q
authors.initials: HQ
authors.lastname: Huynh
authors.forename: Leanne
authors.initials: L
authors.lastname: Shirton
authors.forename: Justine M
authors.initials: JM
authors.lastname: Turner
mesh_terms: D000293:Adolescent; D000339:Affect; D000416:Alberta; D001007:Anxiety / Q000209:etiology; D001071:Appointments and Schedules; D017028:Caregivers / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D016099:Endoscopy, Gastrointestinal / Q000523:psychology; D005260:Female; D005762:Gastroenterology / Q000458:organization & administration*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D010045:Outpatients / Q000523:psychology; D010353:Patient Education as Topic / Q000592:standards; D017060:Patient Satisfaction; D012017:Referral and Consultation; D013997:Time Factors; D014850:Waiting Lists