The Global Rating Scale in clinical practice: A comprehensive quality assurance programme for endoscopy departments

BackgroundThe Global Rating Scale is an endoscopy quality assurance programme, successfully implemented in England. It remains uncertain whether it is applicable in another health care setting.AimTo assess the applicability of the Global Rating Scale as benchmark tool in an international context.MethodsEleven Dutch endoscopy departments were included for a Global Rating Scale-census, performed as a cross-sectional evaluation, July 2010. Two Global Rating Scale-dimensions – ‘clinical quality’ and ‘patient experience’ – were assessed across six items using a range of levels: from level-D (basic) to level-A (excellent). Construct validity was assessed by comparing department-specific colonoscopy audit data to GRS-levels.ResultsFor ‘clinical quality’, variable scores were achieved in items ‘safety’ (9% = B, 27% = C, 64% = D) and ‘communication’ (46% = A, 18% = C, 36% = D). All departments achieved a basic score in ‘quality’ (100% = D).For ‘patient experience’, variable scores were achieved in ‘timeliness’ (18% = A, 9% = B, 73% = D) and ‘booking-choice’ (36% = B, 46% = C, 18% = D). All departments achieved basic scores in ‘equality’ (100% = D).Departments obtaining level-C or above in ‘information’, ‘comfort’, ‘communication’, ‘timeliness’ and ‘aftercare’, achieved significantly better audit outcomes compared to those obtaining level-D (p < 0.05).ConclusionThe Global Rating Scale is appropriate to use outside England. There was significant variance across departments in dimensions. Most Global Rating Scale-levels were in line with departments’ audit outcomes, indicating construct validity.