Patient Satisfaction with Family Physician Colonoscopists

The Journal of the American Board of Family Medicine

Upneet K. Nijjar¹  Matthew W. Short¹  John A. Edwards¹ 

[1] From the Department of Family Medicine, Madigan Army Medical Center, Tacoma, WA

关键词: Colonoscopy;    Colorectal Cancer Screening;    Patient Satisfaction;    Quality of Care;   

DOI  :  10.3122/jabfm.2011.01.100112

学科分类：过敏症与临床免疫学

来源: The American Board of Family Medicine

【 摘 要 】

Purpose: Assessing patient satisfaction after endoscopy with a standardized survey is recommended by gastrointestinal professional societies. The purpose of this study was to assess both patient satisfaction with colonoscopy performed by family physicians and physicians’ technical competence in colonoscopy.

Methods: Modified Group Health Association of America 9 surveys were sent to all 230 patients who received a colonoscopy by family physicians at Madigan Army Medical Center from June to December 2007. Responses were graded on a 5-point Likert scale (LS), with a score of ≥3 (good to excellent) defined as a favorable response. Procedure reports and medical records were reviewed for all patients, and selected quality indicators were compared with recommended colonoscopy standards.

Results: Sixty-nine percent of patients responded: 85 men (54%; mean age ± SD, 54.9 ± 5.6 years) and 73 women (46%; mean age ± SD, 54.3 ± 4.3 years). The overall rating of the visit received a favorable response rate of 98% (average LS rating, 4.6). Nearly all patients said they would have the procedure repeated by the same physician (98%) and at the same facility (98%). The overall reach-the-cecum rate was 100%. Adenomas were detected in 22% of women and 36% of men. All polyps measuring <2 cm were removed, and 99% of the procedures had scope withdrawal times of at least 6 minutes. Hemostasis techniques were used for 2 patients after polypectomy. There were no perforations.

Conclusion: Family physicians can perform colonoscopy with a high level of accuracy, safety, and patient satisfaction.

• Colonoscopy
• Colorectal Cancer Screening
• Patient Satisfaction
• Quality of Care

Screening for colorectal cancer is recommended beginning at age 50,¹ with colonoscopy being the preferred prevention strategy recommended by the American College of Gastroenterology.² There has been a substantial demand for colonoscopy based on these recommendations and a growing population over age 50.³ Family physicians have contributed to meeting this demand by providing colonoscopy services.^4–11

The American Society for Gastrointestinal Endoscopy (ASGE) and the American College of Gastroenterology (ACG) have recently established practical quality measures to grade endoscopy performance.^12–14 Assessing patient satisfaction with gastrointestinal endoscopic procedures is one of the postprocedure indicators recommended by the ASGE and ACG to evaluate the quality of outcomes.^14,15 The use of a modified Group Health Association of America (GHAA) 9 patient satisfaction survey has been recommended because it has been validated in numerous patient populations and has been in existence for more than 20 years.¹⁶ Despite the availability and common use of this patient satisfaction survey, little published data exists about colonoscopy performed by gastroenterologists,¹⁷ and no data exists about colonoscopy performed by primary care physicians.

One of the questions in the GHAA 9 survey asks patients to assess the technical skills of their physician. This question has been difficult to validate because patients do not feel qualified to answer the question.¹⁷ Additional quality indicators have been recommended by the ASGE and ACG to evaluate technical colonoscopy skills.¹³ The purpose of this study was to assess both patient satisfaction with colonoscopy performed by family physicians using a modified GHAA 9 questionnaire and family physician technical competence in colonoscopy using recommended quality indicators.

【 授权许可】

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