Abstract
Background. The United Kingdom Global Rating Scale (GRS-UK) measures unit-level quality metrics processes in digestive endoscopy. We evaluated the psychometric properties of its Canadian version (GRS-C), endorsed by the Canadian Association of Gastroenterology (CAG). Methods. Prospective data collection at three Canadian endoscopy units assessed GRS-C validity, reliability, and responsiveness to change according to responses provided by physicians, endoscopy nurses, and administrative personnel. These responses were compared to national CAG endoscopic quality guidelines and GRS-UK statements. Results. Most respondents identified the overarching theme each GRS-C item targeted, confirming face validity. Content validity was suggested as 18 out of 23 key CAG endoscopic quality indicators (78%, 95% CI: 56–93%) were addressed in the GRS-C; statements not included pertained to educational programs and competency monitoring. Concordance ranged 75–100% comparing GRS-C and GRS-UK ratings. Test-retest reliability Kappa scores ranged 0.60–0.83, while responsiveness to change scores at 6 months after intervention implementations were greater (P < 0.001) in two out of three units. Conclusion. The GRS-C exhibits satisfactory metrics, supporting its use in a national quality initiative aimed at improving processes in endoscopy units. Data collection from more units and linking to actual patient outcomes are required to ensure that GRS-C implementation facilitates improved patient care.
Highlights
Since 2010, all Canadian provinces have either announced or started implementing organized CRC screening
The Global Rating Scale (GRS)-United Kingdom (UK) has proven effective in improving endoscopy services, and while no formal validation studies for GRS-UK have been performed, some groups in the UK, Netherlands, and Scotland have attempted to validate patient involvement in the GRS [8, 9]
We examined the percentage of statements in common for each item in the GRS-C and the reference GRS-UK
Summary
Since 2010, all Canadian provinces have either announced or started implementing organized CRC screening. Central to the CAG’s program is the Global Rating Scale (GRS), an endoscopy quality improvement tool that was developed in 2005 in the United Kingdom (UK). This 12-item GRS-UK questionnaire was developed following meetings with endoscopy staff [6, 7] who were instructed to consider areas that would be important for a patient undergoing endoscopy. Prospective data collection at three Canadian endoscopy units assessed GRS-C validity, reliability, and responsiveness to change according to responses provided by physicians, endoscopy nurses, and administrative personnel. These responses were compared to national CAG endoscopic quality guidelines and GRS-UK statements. Data collection from more units and linking to actual patient outcomes are required to ensure that GRS-C implementation facilitates improved patient care
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