Background The Canada-Global Rating Scale (C-GRS) is a web-based, patient centered endoscopy quality improvement tool. It assesses the quality of the services an endoscopy unit provides in two dimensions: clinical quality and the quality of the patient experience. It also allows each endoscopy unit to choose priority areas for future QI activities. Scores are submitted twice a year to a centralized website by the local endoscopy site’s C-GRS working group. Uptake of the C-GRS in Alberta has been historically poor with only 22/50 sites submitting a C-GRS survey in 2016. A provincial C-GRS project team was formed in 2018 to spearhead provincial implementation of the C-GRS. Alberta Health Services approved a C-GRS policy in 2020 mandating regular use of the C-GRS in all provincial endoscopy units. Aims The purpose of this project is to describe a process of focused C-GRS implementation using Innovation Learning Collaborative (ILC) methodology. Methods An ILC is a process meant to drive clinical pathway practice changes to achieve system-wide improvements. Inter-professional teams meet at least three times over a 12–18 month period at Learning Sessions to share successes, learnings, resources and data. A balanced scorecard (Figure 1) is used to track C-GRS progression and regression. Action Period meetings are held in between the Learning Sessions to help build collaboration and support the teams. Results The first of three in-person ILC Learning Sessions was successfully held on November 29, 2019. 37 out of 50 sites in Alberta attended. Each site committed to working on up to 6 C-GRS descriptors during the course of the ILC. An updated scorecard is provided after each C-GRS cycle. An average of 25 sites attended Action Period meetings to report on progress and to share learnings with other sites. 44 endoscopy sites submitted a follow-up C-GRS survey in the spring 2020 cycle (an increase of 22 from 2016). 84% of sites demonstrated improvement with the average number of items improved at 5.1 Conclusions Use of ILC methodology with a balanced scorecard approach can achieve system level improvement within a relatively short time frame. Funding Agencies None

Background The Canada-Global Rating Scale (C-GRS) is a web-based, patient centered endoscopy quality improvement tool. It assesses the quality of services a unit provides in two dimensions: clinical quality and patient experience. Endoscopy units submit results to the Canadian Association of Gastroenterology twice a year. In Alberta, units receive an A, B, C or D grade for each of the 12 C-GRS Items and a C-GRS score. The C-GRS promotes that patient feedback is sought annually. Patient feedback is important because it informs practice improvement opportunities. However, survey creation, distribution, analysis and reporting can be time consuming and costly for an endoscopy unit and is a potential barrier to participation. Aims The purpose of this quality improvement project is to demonstrate how a provincial infrastructure, which includes coordination, management and reporting of an endoscopy patient satisfaction survey, can enhance provincial endoscopy unit survey participation and facilitate C-GRS compliance. Methods The Digestive Health Strategic Clinical Network (DHSCN), the Alberta Colorectal Cancer Screening Program and Primary Data Support (PDS) collaborated on the Provincial Endoscopy Patient Experience Survey (PEPES) in 2019. An existing paper survey was adapted to meet the needs of the 50 endoscopy units in AB with the addition of an electronic version. Education about the PEPES process was provided via a webinar and site visits. Each unit was responsible for distribution of the surveys to their patients. PDS coordinated the paper survey process and the DHSCN managed the electronic survey submissions. Paper survey results were merged with electronic PEPES data. A summary report was provided to units and shared with each AHS Zone Endoscopy Executive Leadership Team. Results Provincially coordinated implementation of the PEPES fosters compliance with C-GRS criteria. Participating endoscopy units were able to achieve at minimum 9 C-GRS descriptors and improve their C-GRS score in the following 7 of the 12 C-GRS Items: consent, comfort, equality, booking, privacy, aftercare and feedback. Initial enrollment in the PEPES increased with the onset of provincial coordination (Figure 1). However, subsequent participation was negatively impacted by COVID-19 as many endoscopy units in AB were required to decrease their capacity and redeploy staff. Conclusions A provincially coordinated approach to the management of an endoscopy patient experience survey is an effective way to enhance site participation and improve C-GRS scores. Units can focus on actioning survey results, rather than the burden of survey administration. Future work includes comparison of results across sites allowing for potential provincial equity issues to be addressed. Funding Agencies None