Patients' views on their experience of the delivery of single-sex accommodation within the endoscopy department: is it worth it?

Abstract

Introduction: Provision of single-sex accommodation (SSA) in hospitals is a key National Health Service objective. Department of Health policy to eliminate mixed-sex accommodation (MSA) was implemented in our endoscopy department in 2011. We found no published studies of patients' views on MSA in endoscopy units.

Aim: We explored patients' views on MSA and their experience of attending our unit at Royal Albert Edward Infirmary (Wigan, UK) since implementation of the SSA policy.

Methods: Patients attending the endoscopy unit August-October 2012 and February-April 2015 were invited to participate. Views were surveyed using a 10-point questionnaire.

Results: 155 patients were included. A minority were aware of national (36%) or local (39%) policies regarding MSA provision. Only 20.0% and 22.9% reported that they would feel uncomfortable changing behind a curtain or waiting in a gown in a mixed-sex area, respectively. Most of those that felt uncomfortable (81% and 71%) were female, and women ranked importance of SSA significantly higher than men. However, both sexes ranked importance of SSA significantly lower than that of prompt investigation/treatment. Admissions to an alternative recovery area specifically to maintain SSA compliance reduced from 25% (2012) to 8% (2015), following simple measures to improve list efficiency, with corollary reduction in reports of compromised patient experience.

Conclusions: SSA is an important healthcare priority for some patients, especially women. However, most consider prompt investigation/treatment a much higher priority. Measures to comply with SSA can negatively affect patient experience. However, we demonstrate that simple measures can result in significant improvements in service delivery and patient experience while remaining compliant with SSA guidance.

Keywords: ENDOSCOPY.

Figure 1

Patients’ views when asked would you feel uncomfortable/vulnerable (A) getting changed behind a curtain and (B) waiting in a gown, if there were other patients of the opposite sex in the same area. Bar charts show the number of patients reporting they would (‘YES’) or would not (‘NO’) be uncomfortable in each situation; left bars are for patients surveyed in cohort A (2012), right bars for those surveyed in cohort B (2015). Pie charts below each column depict the proportion of male and female patients (where sex provided; cohorts A and B combined). p Values indicate significance of any difference in response by sex (cohorts A and B combined), and are derived from contingency table comparison and Fisher's exact test.

Figure 2

(A) Visual depiction of all patients’ ranking of the importance of access to prompt investigations/treatment and the provision of separate male and female accommodation in endoscopy. Median and modal rankings are shown for each feature. Statistical significance of the difference between median ranks for each feature is shown and calculated using the Wilcoxon matched-pairs signed rank test. Crosses on the visual analogue scale represent the median rank for each feature; whiskers indicate the IQR. (B) Bar chart showing the proportion of total patients selecting each rank (1=least important, 10=most important) for each feature. Ix, investigations; Mx, management; SSA, single-sex accommodation.

Figure 3

(A) Visual depiction of male and female rankings of the importance of access to prompt investigations/treatment and the provision of separate male and female accommodation in endoscopy. Symbols on the visual analogue scale represent the median rank for men and women for each feature; whiskers indicate the IQR. Median and modal rankings returned by men and women are provided for each feature. Statistical significance of the difference between median rank reported by men and women for each feature is shown and calculated using the Mann–Whitney U test. (B) Bar chart showing the proportion of male and female patients choosing each rank (1=least important to 10=most important) for the importance of provision of single-sex accommodation.