Benchmarking services in outpatient hysteroscopy (OPH): A quality improvement project

To develop a survey evaluating women's experience of outpatient hysteroscopy (OPH) to generate data to benchmark OPH practice in the UK that can be used to optimise women's experience of OPH and improve services.

Quality improvement project and a population-based national survey.

77 hospitals with outpatient hysteroscopy (OPH) services across the UK collected data over two month-period (October-November 2019).

5151 women attending for outpatient hysteroscopy.

A new OPH-Patient Satisfaction Survey (OPH-PSS) was developed using a multi-disciplinary approach. Good practice guidance in hysteroscopy and existing survey's provided content for the survey. Pilot testing identified aspects of the women's OPH journey that contributed to a final survey. The final OPH-PSS was rolled out nationally to generate data for benchmarking OPH services.

The adequacy of OPH services reflected in women's experience of their OPH journey and the quality of care being delivered.

The majority (3193, 76 %) of hysteroscopic procedures were recorded as diagnostic. Most (4485, 87 %) women received adequate information regarding their OPH. 4581, 89 % of women agreed that they were given an opportunity to discuss analgesia and 5033, 97 % of women felt involved in their care. As regards patient experience, although pain was reported by most women (4490, 87 %), just over half considered the degree of pain as slight. While (787, 15 %) felt pain throughout their OPH with 1 in 10 women feeling anxious. Although, 1217 (26 %) women experienced feeling faint most only felt this slightly. Overall, more than 90 % (4867) of women considered the OPH service good. The mean score rating for the overall level of care was considerably high (9.7/10). Comparative pain scores for OPH vs the worst pain felt during a menstrual period showed OPH procedures to be less painful except for endometrial ablation (P < 0.001).

This novel survey, evaluating women's experience of OPH (OPH-PSS), provides a useful tool for benchmarking performance across different OPH units. Overall, the information provided to women and their subsequent experience of OPH is good, but pain is common.