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Canadian Journal of Gastroenterology
Volume 24, Issue 10, Pages 607-613
Original Article

A Prospective Audit of Patient Experiences in Colonoscopy Using the Global Rating Scale: A Cohort of 1187 Patients

Vincent de Jonge,1 Jerome Sint Nicolaas,1 Eoin A Lalor,3 Clarence K Wong,4 Brennan Walters,5 Anand Bala,6 Ernst J Kuipers,1,2 Monique E van Leerdam,1 and Sander JO Veldhuyzen van Zanten3

1Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
2Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
3Divisions of Gastroenterology and Hepatology, University of Alberta Hospital, Canada
4Royal Alexandra Hospital, Canada
5Misericordia Community Hospital, Canada
6Grey Nuns Community Hospital, Edmonton, Alberta, Canada

Received 1 December 2009; Accepted 8 February 2010

Copyright © 2010 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: The Global Rating Scale (GRS) comprehensively evaluates the quality of an endoscopy department, providing a patient-centred framework for service improvement.

OBJECTIVE: To assess patient experiences during colonoscopy and identify areas that need service improvement using the GRS.

METHODS: Consecutive outpatients undergoing colonoscopy were asked to complete a pre- and postprocedure questionnaire. Questions were based on GRS items and a literature review. The preprocedure questionnaire addressed items such as patient characteristics and information provision. The postprocedure questionnaire contained questions regarding comfort, sedation, the attitude of endoscopy staff and aftercare.

RESULTS: The preprocedure questionnaire was completed by 1187 patients, whereas the postprocedure part of the questionnaire was completed by 851 patients (71.9%). Fifty-four per cent of patients were first seen in the outpatient clinic. The indication for colonoscopy was explained to 85% of the patients. Sixty-five per cent of the patients stated that information about the risks of colonoscopy was provided. Sedation was used in 94% of the patients; however, 23% judged the colonoscopy to be more uncomfortable than expected. Ten per cent of patients rated the colonoscopy as (very) uncomfortable. Preliminary results of the colonoscopy were discussed with 87% of patients after the procedure. Twenty-one per cent of the patients left the hospital without knowing how to obtain their final results. Being comfortable while waiting for the procedure (OR 9.93) and a less uncomfortable procedure than expected (OR 2.99) were important determinants of the willingness to return for colonoscopy.

CONCLUSIONS: The present study provided evidence supporting the GRS in identifyng service gaps in the quality of patient experiences for colonoscopy in a North American setting. Assessing experiences is useful in identifying areas that need improvement such as the provision of pre- and postprocedure information.