British Society of Gastroenterology position statement on patient experience of GI endoscopy

Abstract

This position statement provides a framework on patient experience of gastrointestinal endoscopy, with recommendations and suggestions for practice to ensure high quality patient experience. This area is not previously covered by British Society of Gastroenterology (BSG) guidelines or position statements and is an important addition to this field. The National Institute of Health and Care Excellence compliant BSG guideline development process was used throughout. A metanarrative review of the literature (systematic review plus qualitative data) on patient experience of GI endoscopy was performed and was used as the basis for development of statements by the writing subgroup of the Guideline Development Group (GDG). Proposed statements were evaluated by each member of the GDG (consisting of patient representatives, gastroenterologists, surgeons, a nurse endoscopist, an endoscopy nurse, a health psychologist and a public health research officer) on a scale from 1 (strongly disagree) to 5 (strongly agree) with 80% agreement required for consensus to be reached. Where consensus was not reached, a Modified Delphi process was used to re-evaluate and modify statements until consensus was reached or the statement discarded. Finalised Statements and evidence quality were evaluated at a GDG round table meeting. The GRADE tool was used to assess strength of recommendations and evidence. 50 statements are included, covering 10 key domains, including definitions and terms, patient experience key principles, how and what information is offered to patients, how experience is measured, options available to improve patient experience, sedation practice, pre-assessment, endoscopy under difficult or complex circumstances, and departmental elements.

Non-pharmacological interventions to improve the patient experience of colonoscopy under moderate or no sedation: a systematic review protocol

“…A preliminary literature review has shown heterogeneity in the types of instruments used to assess the patient experience and there is no existing consensus on how to prioritise measures of patient experience. 17 22 Therefore, studies reporting any quantitative measure of patient experience, including satisfaction, anxiety, pain or discomfort as an outcome, will be included. Secondary outcomes will include willingness to repeat the procedure, adenoma detection rate, polyp detection rate, caecal intubation rate, caecal intubation time, total colonoscopy time, endoscopist satisfaction, cost in dollars and the occurrence of any adverse events (eg, bleeding and perforation).…”

“…The British Society of Gastroenterology’s position statement on patient experience during gastrointestinal (GI) endoscopy affirms not only patient experience as a core dimension of healthcare quality but also enumerates few options available to endoscopists to alter the patient experience during GI endoscopy. 17 To inform efforts to improve the patient experience of colonoscopy and potentially reduce the use of deep sedation for routine colonoscopy, additional research is needed.…”

JAG consensus statements for training and certification in flexible sigmoidoscopy

“…The BSG position statement on patient experience of GI endoscopy states that discomfort, pain and embarrassment during the procedure should be controlled and kept to a minimum 23. The BSG colonoscopy guidelines recommend that rates of moderate-severe discomfort should be <10%.…”

“…The BSG position statement on patient experience of GI endoscopy states that discomfort, pain and embarrassment during the procedure should be controlled and kept to a minimum. 23 The BSG colonoscopy guidelines recommend that rates of moderate-severe discomfort should be <10%. We recommend that this KPI should apply to FS and measured using the 5-point modified Gloucester comfort scale, 24 with nurse-reported scores of 4 and 5 indicating significant discomfort.…”

Measuring patient experience of Cytosponge using the Newcastle ENDOPREM

“…Patient experience is a crucial marker of quality of GI procedures and impacts patient attendance and reattendance. All patient-reported experience measures should be patient centred; derived from and completed by patients 4. Previous GI endoscopy patient experience questionnaires were often developed by clinicians with little or no patient input, typically focused only on comfort and were recorded by healthcare professionals.…”