Objective/Background:

A quality improvement patient satisfaction survey to evaluate women’s experience and improve our outpatient hysteroscopy service at Orpington Hospital.

Design:

20 questionnaires were used in the month of October 2022, after hysteroscopy to review patient’s experience and their comments and suggestions.

Method:

We used British Society for Gynaecological Endoscopy (BSGE) OPH- Patient Satisfaction Survey (OPH- PSS) Performa to collect data and to evaluate current clinical practice.

Results:

In our department OPH was mainly diagnostic. We performed a prospective study in our District General Hospital (DGH) to review patients experience and to improve ambulatory hysteroscopy service.

Only 60% (12/20) women received adequate information prior to the procedure.

Regarding pain, 45% (9/20) felt procedure was painful, whereas 55% reported no pain or slight discomfort. While 3/20 (15 %) felt pain throughout their OPH.

Although the information leaflets prior to the procedure was received, only 65% women took the painkillers before coming to the hospital, two patients reported that they were aware of the analgesia but decided not to take it. 3/20 mentioned they wish they knew about the pre-operative analgesia.

One woman felt anxious constantly during the procedure, while 7/20 were not anxious at all. 60% (12/20) were slightly anxious. 90% women reported they were not distressed or embarrassed.

90% (18/20) women strongly agreed, (10% agreed) that they were treated with respect and dignity and were given enough privacy. 19/20 (95%) agreed they received adequate information regarding recovery and management plan.

Overall, 85% women had excellent experience and 15% (3/20) reported good experience. 85% women agreed to have the same procedure in the same way if a further need arise in future.

Patients’ Comments:

· Lovely team looking after me, keeping me entertained and calm

· The staff were amazing! Thank you

· Staff & consultant were extremely reassuring and put me at ease. My only negative was I waited for 40mins

· Bit of long wait and thank you to all staff who were so kind to me.

Recommendations:

· Produce Local Patient Information Leaflet (PIL) for outpatient Hysteroscopy

· Use RCOG outpatient hysteroscopy PIL (during the mean time)

· Use of analgesia (nonsteroidal anti-inflammatory drugs) should be discussed while putting on the list or taking first stage consent for ambulatory hysteroscopy.

· Other options: Intracervical block, paracervical block, transcervical block, and topical analgesia should be mentioned to the women.

· Pre-procedure counselling, if patients have information about the procedure in advance, it will help in reducing the waiting time.

Conclusion:

Hysteroscopy in outpatient setting is a safe, successful and well tolerated method without anaesthesia. Our data has suggested that despite pain 100% patient described good to excellent experience. 100% women agreed that they were treated with respect and dignity and were given enough privacy. Overall, more than 85 % of women considered the OPH service good.