Department of Gastroenterology and Hepatology, Royal Liverpool University Hospital, Liverpool, UK.
J Gastrointestin Liver Dis. 2012 Sep;21(3):251-8.
To ensure patient safety, rigorous quality assurance (QA) measures for colonoscopy were introduced for the Bowel Cancer Screening Programme (BCSP) in England. The impact of these high QA measures on patient experience and satisfaction is unknown.
To determine the impact of this high-level QA of colonoscopy on patient satisfaction.
A case controlled study using a retrospective audit & telephone interview patient survey was performed between 1/1/07-01/10/08 on patients that underwent colonoscopy. Data were analyzed by comparing quantitative and qualitative performance colonoscopy indicators in patients within the BCSP with those outside the programme (NON-BCSP).
720 patients that had undergone day case colonoscopy.
Accredited BCSP centre: University Hospitals Aintree, UK.
Comparing patient satisfaction between BCSP to NON-BCSP populations.
Uptake was 68% (n=488). Caecal intubation rate (CIR) was higher (99 v 91%; p=0.001), and sedation doses lower in BCSP compared to NON-BCSP (Midazolam dose Median [IQR] (1 [0, 2] v 2 [1, 3] mg; respectively p=0.0001). For patient satisfaction and experience, scores were high and pain scores were low in both groups; with no statistically significant difference between groups. However, willingness to have a repeat procedure was higher in BCSP (p=0.001).
Whilst superior CIR with less sedation within BCSP, overall scores were similar for patient satisfaction, both in and outside the programme. With the higher 'willingness for repeat' within BCSP, a positive impact of higher level of QA is suggested and that good patient experience can be achieved with minimal conscious sedation in expert hands.
为确保患者安全，英国的肠癌筛查计划（BCSP）引入了严格的质量保证（QA）措施。这些高 QA 措施对患者体验和满意度的影响尚不清楚。
确定这种高水平的结肠镜 QA 对患者满意度的影响。
在 2007 年 1 月 1 日至 2008 年 10 月 1 日期间，对接受结肠镜检查的患者进行了一项病例对照研究，采用回顾性审核和电话采访患者调查。通过比较 BCSP 内和计划外（NON-BCSP）患者的定量和定性结肠镜检查指标来分析数据。
720 例日间住院结肠镜检查患者。
英国安特里大学医院认可的 BCSP 中心。
比较 BCSP 和 NON-BCSP 人群的患者满意度。
吸收率为 68%（n=488）。BCSP 的盲肠插管率（CIR）更高（99 比 91%；p=0.001），镇静剂量也低于 NON-BCSP（咪达唑仑剂量中位数[IQR]（1 [0, 2] 比 2 [1, 3] mg；分别 p=0.0001）。对于患者满意度和体验，两组的评分都很高，疼痛评分都很低；两组之间没有统计学上的显著差异。然而，BCSP 组再次接受手术的意愿更高（p=0.001）。
尽管 BCSP 中 CIR 更高，镇静剂用量更少，但无论在计划内还是计划外，患者满意度的总体评分都相似。BCSP 中更高的“再次接受意愿”表明，更高水平的 QA 具有积极影响，并且在专家的手中，最小意识镇静可以实现良好的患者体验。
