The intention of this service evaluation was to assess patient satisfaction within the Urodynamics department using the ICIQ-S-UDS questionnaire. This was conducted following the UPSTREAM study which assessed patient experience of urodynamics and is a basic requirement for improving quality in physiological sciences (IQIPS). Patient experience should be regularly investigated, and all data collected should be utilised to improve all aspects of the patient journey and drive positive change within the urodynamic department.

The ICIQ-S-UDS employs 9 closed ended questions and rating scales (from 1-10) to gather numerical data. It also contains free text space for patients to elaborate and provide qualitative feedback. These questionnaires were given to patients to complete post urodynamic procedure.

The department collected a total of 64 patients over a three-month period in 2022, with no discrepancies to gender, age, or outcome of urodynamics. The responses were from 37 females, 23 males and 1 unspecified gender.

Written information about the test: 
86% of patients received correspondence prior to the test, and found it easy to understand, whilst 6% received correspondence but found the information could have been easier to understand. 8% of patients did not receive correspondence before their urodynamic investigation.

Health professionals’ explanation prior to investigation: 
93% of patients felt the test was explained well. 5% of patients felt the test was explained well to some extent. 1 patient denied any explanation was given before the test. 

Opportunity to ask questions: 
97% of patients completely agreed that they were given the opportunity to ask questions and had them answered satisfactorily. The remaining 3% agreed to some extent.

Competence and professionalism:
97% of patients completely agreed that the staff were competent and professional throughout their appointment. The remaining 3% agreed to some extent. 

Comfort during test:
98% of patients felt that everything was done to keep them comfortable during the test. The remaining 1 patient agreed to some extent. 

Privacy and dignity:
100% of patients felt their privacy and dignity was respected completely during the test.

Department recommendation:
95% of patients would definitely recommend the department to friends or relatives with similar problems. The remaining 5% would probably recommend the department. 

Overall satisfaction: 
When asked to rate their overall satisfaction of the urodynamic experience, 85% of patients reported complete satisfaction (10/10). The remaining 15% reported a 7 or above on their rating scale with 10 being fully satisfied.

Overall satisfaction rates were high, which support findings in the UPSTREAM (men only) study [1] that patients tolerate the test well. In a previous study, it was highlighted that anxiety and embarrassment were associated with urodynamics despite being well tolerated [2]. As a result of this questionnaire within the urodynamic department, we have identified some areas for improvement. 

The International Continence Society, in their 2016 urodynamics standardisation report, have highlighted what should be included in a urodynamics information leaflet. Improving correspondence to patients before the test and modification of the urodynamics leaflet to improve clarity is very important. One patient raised the problem of the incorrect time being listed on their appointment letter, and not receiving a urodynamic leaflet. Issues in this remit will be addressed by the admin team following urodynamic team meetings. 

It is pertinent that time is taken to fully explain the procedure and its associated risks prior to commencing urodynamics. The above data identified that 7% of patients felt they did not receive sufficient information to make an informed decision and thus there needs to be more time and effort invested in ensuring that all patients receive adequate information to give informed consent prior to the procedure. 

The patient feedback has been made available to all staff gaining informed consent, reiterating the crucial nature of consent. 

The department will continue to record these questionnaires quarterly so any underlying issues or complaints can be addressed in a timely manner, following guidance from the NHS Patient Experience book [3].

Selman, L., Ochieng, C., Lewis, A., Drake, M. and Horwood, J., 2018. Recommendations for conducting invasive urodynamics for men with lower urinary tract symptoms: Qualitative interview findings from a large randomized controlled trial (UPSTREAM). Neurourology and Urodynamics, 38(1), pp.320-329. Accessed from https://onlinelibrary.wiley.com/doi/10.1002/nau.23855
Suskind, A.M., Clemens J.Q., Kaufman, SR., Oldendorf A., Malaeb, BS., Jandron, T., Cameron, A.P., 2015. Patient perceptions of physical and emotional discomfort related to urodynamic testing; a questionnaire-based study in men and women with and without neurologic conditions. Urology 85(3), pp.547-551. Accessed from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4349219/
NHS Institute for Innovation and Improvement, 2013. The Patient Experience Book. 1st ed. [ebook] NHS Institute for Innovation and Improvement. Available at: https://www.england.nhs.uk/improvement-hub/wp-content/uploads/sites/44/2017/11/Patient-Experience-Guidance-and-Support.pdf