Hitchins C R, Lawn A, Whitehouse G, McFall M R
Department of Colorectal Surgery, Worthing Hospital, Western Sussex Hospitals NHS Trust, Worthing, UK.
Colorectal Dis. 2014 Aug;16(8):616-9. doi: 10.1111/codi.12613.
The NHS Cancer Plan describes initiatives to improve patient care in the UK, including the two-week rule cancer referral pathway. To meet this target a straight to test (STT) endoscopy service was devised to expedite diagnosis of suspected colorectal cancer. Our novel study aimed to determine patient satisfaction with this new approach to rapid access investigation.
An anonymized questionnaire was posted to 300 patients who had undergone STT endoscopy in our unit between January and June 2010. It assessed satisfaction with the service overall, time from referral to investigation, pre-test information, bowel preparation instructions and time to results as well as preference for a traditional pre-test or post-test outpatient appointment and awareness that the referral was for suspected bowel cancer.
In all, 174 questionnaires were obtained (58% yield; mean age 68.8; 44.8% men). 82.2% of patients were 'very satisfied' with the service overall, 82.8% with time from referral to test, 75.2% with time from test to results, 73% with endoscopy information and 69.5% with bowel preparation instructions. Eight per cent would rather have seen a specialist prior to endoscopy, 31.6% would have preferred a post-test appointment and 68.4% of patients were aware that referral was for suspected bowel cancer.
Straight to test is popular with patients. It offers a fast and cost effective service in the diagnosis of colorectal cancer and meets national targets whilst reducing the volume burden on outpatient clinics. However, its success heavily relies on accurate communication between general practitioner, patient and secondary care.
英国国民健康保险制度（NHS）癌症计划描述了改善英国患者护理的举措，包括两周规则癌症转诊途径。为实现这一目标，设计了一种直接检测（STT）内窥镜检查服务，以加快疑似结直肠癌的诊断。我们的新研究旨在确定患者对这种快速获取检查新方法的满意度。
向2010年1月至6月间在我们科室接受STT内窥镜检查的300名患者发放了一份匿名问卷。问卷评估了患者对整体服务、从转诊到检查的时间、检查前信息、肠道准备说明、获取结果的时间的满意度，以及对传统检查前或检查后门诊预约的偏好，还有患者是否知晓转诊是针对疑似肠癌。
共收回174份问卷（回收率58%；平均年龄68.8岁；男性占44.8%）。82.2%的患者对整体服务“非常满意”，82.8%的患者对从转诊到检查的时间满意，75.2%的患者对从检查到获取结果的时间满意，73%的患者对内窥镜检查信息满意，69.5%的患者对肠道准备说明满意。8%的患者希望在内窥镜检查前看专科医生，31.6%的患者更喜欢检查后预约，68.4%的患者知晓转诊是针对疑似肠癌。
直接检测很受患者欢迎。它在结直肠癌诊断中提供了快速且具成本效益的服务，符合国家目标，同时减轻了门诊的工作量负担。然而，其成功很大程度上依赖于全科医生、患者和二级医疗之间的准确沟通。
